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目的:分析感染耐碳青霉烯类药物鲍曼不动杆菌(CRABC)的相关危险因素,为临床工作提供参考依据。方法:收集本院2015年1-12月鲍曼不动杆菌培养阳性的住院病人的年龄、性别、住院天数、病区、侵入性检查及抗生素治疗情况,根据CRABC和碳青霉烯类敏感鲍曼不动杆菌(CSABC)两组收集的信息,运用SPSS 16.0进行单因素和多因素Logistic回归分析。结果:纳入研究的280株鲍曼不动杆菌中有201株是CRABC,占71.8%。多因素Logistic回归分析显示入住ICU(OR0.313,95%CI 0.107-0.739,P=0.001 0)、气管插管(OR0.279,95%CI0.122-0.640,P=0.003)、气管切开(OR0.251,95%CI 0.088-0.717,P=0.010)、手术引流(OR0.322,95%CI0.132-0.788,P=0.013)和碳青霉烯类药物(OR0.461,95%CI0.230-0.922,P=0.029)的治疗具有统计学意义。结论:入住ICU、气管插管、气管切开、手术引流和碳青霉烯类抗生素的经验性治疗是感染CRABC的危险因素,应该引起临床医生的重视。
Objective: To analyze the risk factors of infection with carbapenem-resistant Acinetobacter baumannii (CRABC), and to provide a reference for clinical work. Methods: The age, sex, days of hospitalization, ward, invasive examination and antibiotic treatment of Acinetobacter baumannii-positive inpatients from January to December in 2015 were collected. According to CRABC and carbapenem sensitive The data collected from the two groups were analyzed by univariate and multivariate logistic regression analysis using SPSS 16.0. Results: Of the 280 strains of Acinetobacter baumannii included in the study, 201 were CRABC, accounting for 71.8%. Multivariate Logistic regression analysis showed that tracheotomy (OR0.279, 95% CI 0.122-0.640, P = 0.003), tracheostomy (OR0.251, 95% CI 0.088-0.717, P = 0.010), surgical drainage (OR0.322, 95% CI0.132-0.788, P = 0.013) and carbapenems (OR0.461, 95% CI0.230-0.922, P = 0.029) was statistically significant. Conclusion: The ICU, tracheal intubation, tracheotomy, surgical drainage and the empirical treatment of carbapenem antibiotics are risk factors for CRABC infection, which should be taken seriously by clinicians.