老年患者耐碳青霉烯类鲍曼不动杆菌血流感染的危险因素和病死率：一项为期十年的回顾性研究

目的 评估老年患者发生耐碳青霉烯类鲍曼不动杆菌(CRAB)血流感染和28天短期死亡相关的危险因素，为预防和治疗CRAB血流感染提供依据。方法 回顾性分析玉林市某医院2013年1月—2022年12月确诊为鲍曼不动杆菌血流感染且年龄≥60岁的老年患者临床资料，包括患者人口统计学、微生物学相关特征及临床结局等数据。选取单变量分析有意义的变量进行二元logistic回归模型和Cox比例风险模型多变量分析，进一步确定感染的独立危险因素，采用Kaplan-Meier曲线进行生存分析。结果 共150例患者纳入研究，其中CRAB血流感染16例，占10.7%,碳青霉烯类敏感鲍曼不动杆菌(CSAB)血流感染134例。老年患者鲍曼不动杆菌血流感染28天短期病死率为15.3%(23/150,95%CI:9.6%～21.1%),其中CRAB血流感染短期病死率(56.3%,9/16)高于CSAB(10.4%,14/134)。深静脉置管(OR:15.598,95%CI:1.831～132.910)和合并其他部位感染(OR:15.449,95%CI:1.497～159.489)与老年患者发生CRAB血流感染相关。老年...

Risk factors and mortality for carbapenem-resistant Acinetobacter baumannii bloodstream infection in elderly patients: a 10-year retrospective study

Objective To assess the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI) and 28-day short-term mortality in elderly patients, and provide reference for the prevention and treatment of CRAB BSI. Methods Clinical data of patients aged ≥ 60 years and diagnosed with AB BSI in a hospital in Yulin City from January 2013 to December 2022 were retrospectively analyzed, including demogra-phic and microbiological characteristics, as well as clinical outcomes of the patients. Variables which were significant in univariate analysis were selected for multivariate analysis using binary logistic regression model and Cox proportional hazards model. Independent risk factors for infection were further determined, and survival analysis was performed using Kaplan-Meier curve. Results A total of 150 patients were included in the study, out of which 16 patients (10.7%) had CRAB BSI and 134 had carbapenem-sensitive AB (CSAB) BSI. The 28-day short-term mortality of AB BSI in elderly patients was 15.3% (23/150, 95%CI: 9.6%-21.1%), and the short-term mortality of CRAB BSI was higher than that of CSAB ([56.3%, 9/16] vs[10.4%, 14/134]). Deep venous catheterization (OR: 15.598, 95%CI: 1.831-132.910) and combined infections of other sites (OR: 15.449, 95%CI: 1.497-159.489) were related to CRAB BSI in elderly patients. The independent risk factors for 28-day mortality in elderly patients with AB BSI were hemodialysis (OR: 11.856, 95%CI: 2.924-48.076), intensive care unit admission (OR: 9.387, 95%CI: 1.941-45.385), and pulmonary infection being suspected source of bacteremia (OR: 7.019, 95%CI: 1.345-36.635). Conclusion The occurrence of CRAB BSI in elderly patients is related to the combined infection of other sites and deep vein catheterization. Hemodialysis, admission to ICU, and pulmonary infection being suspected source of bacteremia are independent risk factors for the prognosis of AB BSI in elderly patients.