我院ICU鲍曼不动杆菌感染患者预后的危险因素分析

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Abstract Objective To analyze the risk factors of prognosis in patients with Acinetobacter baumannii infection in our intensive care unit(ICU).Methods A retrospective analysis of 158 cases clinical data of patients with Acinetobacter baumannii infection in the ICU of our hospital from January 2014 to December 2017 was conducted.The patients were divided into survival group and death group according to the 28-day prognosis.The univariate analysis(chi-square test and t test)and multivariate logistic regression analysis were used to calculate the odds ratio(OR)value with 95% confidential interval(CI),and to determine the relevant risk factors for the prognosis of infected patients.Results The source of Acinetobacter baumannii infection strains in our ICU were mainly from sputum of lower respiratory tract accounting for 91.8%.In these infected patients,the mechanical ventilation rate was 72.8%,the usage of multiple antibiotics was 44.9%,and the drug resistance rate was 65.2%.The univariate analysis showed that multiple antibiotics usage and drug resistance of strains were risk factors for death in patients with Acinetobacter baumannii infection.Multivariate Logistic regression analysis also displayed that the above-mentioned two factors were the prognostic ones leading to death of patients with Acinetobacter baumannii infection.Conclusion The patients with Acinetobacter baumannii infection in our hospital characterized advanced age,high mechanical ventilation rate,high antibiotic use rate,and serious drug resistance of strains.It found that the use of multiple antibiotics and drug resistance of strains are risk factors and prognostic factors for death in patients with Acinetobacter baumannii infection.Clinical measures of strengthening infection control,cutting off the route of transmission of Acinetobacter baumannii,intensifying the clinical management of antibacterial drugs,adjusting the antibiotics regimen according to PK/PD,and reducing the resistance of Acinetobacter baumannii should be taken in order to strengthen the prevention and control of Acinetobacter baumannii infection and improve prognosis in infected patients.

Key words： Acinetobacter baumannii Mechanical ventilation Multiple antibiotics Drug resistance Prognosis Risk factors

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