耐碳青霉烯类鲍曼不动杆菌耐药性及感染危险因素剖析.docVIP

耐碳青霉烯类鲍曼不动杆菌耐药性及感染危险因素剖析 　　[摘要] 目的 探讨耐碳青霉烯类鲍曼不动杆菌（CRAB）耐药现状及其感染的危险因素，为临床合理使用抗生素及防控CRAB提供科学依据。 方法 回顾性调查广东医学院附属南山医院（以下简称“我院”）2014年1～12月鲍曼不动杆菌（AB）感染的住院患者的临床资料，分为碳青霉烯类抗生素敏感鲍曼不动杆菌（CSAB）组与CRAB组，将其对19种抗菌药物的耐药情况进行统计，并应用SPSS软件分析CRAB医院感染的危险因素。 结果 CSAB组对大多数抗菌药物敏感率90%，而CRAB组对大多数抗菌药物耐药率90%，两组对米诺环素和替加环素均没有出现耐药菌株；多因素Logistic回归分析表明，入住ICU天数（OR = 2.771，95%CI：1.670～4.59）、使用抗菌药物天数（OR = 1.076，95%CI：1.021～1.13）、使用呼吸机（OR = 4.627，95%CI：1.919～11.15）和使用碳青霉烯类抗生素（OR = 2.980，95%CI：1.033～8.59）是我院CRAB感染的独立危险因素。 结论 抗菌药物选择性压力和外源性感染途径在CRAB的产生和传播中起到非常重要的作用，加强医院多重耐药菌感染管理，合理使用抗菌药物，对减少CRAB感染具有重要意义。 　　[关键词] 耐碳青霉烯类鲍曼不动杆菌；抗菌药物；耐药性；危险因素 　　[中图分类号] R517.9 [文献标识码] A [文章编号] 1673-7210（2016）02（a）-0109-04 　　Analysis of drug resistance and risk factors for infection of Carbapenem-resistant Acinetobacter baumannii 　　LIAN Jie1 CAI Botao1 LEI Xinxing2 　　1.Central Laboratory， Nanshan Hospital Affiliated to Guangdong Medical College， Guangdong Province， Shenzhen 518052， China； 2.Cancer Center， Sun Yat-Sen University， Guangdong Province， Guangzhou 510060， China 　　[Abstract] Objective To investigate drug resistance and risk factors for infection of Carbapenem-resistant Acinetobacter baumannii （CRAB）， moreover provide scientific basis for rational use of antibiotics in clinic and early prevention-control of CRAB infections. Methods Retrospective statistics were performed for the clinical data of inpatients with Acinetobacter baumannii infection in Nanshan Hospital Affiliated to Guangdong Medical College （“our hospital” for short） from January 2014 to December 2014， patients were divided into CSAB group and CRAB group， and resistance to 19 antimicrobial agents were surveyed， also risk factors of CRAB were analyzed by SPSS. Results The sensitive rates of CSAB to most antimicrobial agents were up to 90%， while the resistant rates of CRAB to those drugs were up to 90%. No resistant isolate of these two groups was found to Minocycline and Tigecycline. Multivariate Logistic regression analysis revealed that days stayed a