【摘要】：目的對醫(yī)院患者感染鮑氏不動桿菌(AB)發(fā)生的醫(yī)院獲得性肺炎(HAP)的危險因素和HAP患者的預后進行回顧性分析,為預防和治療醫(yī)院獲得性肺炎尤其是鮑氏不動桿菌感染的HAP提供依據(jù)。方法選取2014年1月-2015年12月醫(yī)院HAP患者114例,通過多元logistic回歸因素進行分析,評價HAP患者感染鮑氏不動桿菌的危險因素與HAP預后相關的危險因素。結(jié)果 114例HAP患者中發(fā)生呼吸機相關性肺炎15例,痰培養(yǎng)為鮑氏不動桿菌29例,患者病死率為43.0%;感染前30天內(nèi)入住ICU、機械通氣、使用碳青霉烯類抗菌藥物為感染鮑氏不動桿菌的HAP獨立危險因素;感染時APACHEII評分18、合并ARDS、合并休克是HAP死亡的獨立危險因素。結(jié)論對于ICU患者、有機械通氣史患者要警惕鮑氏不動桿菌感染風險,盡量減少ICU住院日及機械通氣時間;臨床上濫用碳青霉烯類抗菌藥物會增加住院患者感染鮑氏不動桿菌風險,HAP患者感染時APACHEⅡ評分可以預估患者的預后。
[Abstract]:Objective to analyze retrospectively the risk factors of hospital acquired pneumonia (HAP) in patients with Acinetobacter baumannii (AB) infection and the prognosis of HAP patients. To provide evidence for the prevention and treatment of HAP in hospital-acquired pneumonia, especially Acinetobacter baumannii infection. Methods from January 2014 to December 2015, the risk factors of Acinetobacter baumannii infection in patients with HAP were evaluated by multivariate logistic regression analysis. The risk factors associated with the prognosis of HAP were evaluated in 114 patients with HAP from January 2014 to December 2015. Results there were 15 patients with ventilator-associated pneumonia and 29 patients with Acinetobacter baumannii in sputum culture. The mortality of the patients with HAP was 43. 0%. ICU, mechanical ventilation was performed within 30 days before infection and carbapenems were used as independent risk factors for HAP infection of Acinetobacter baumannii, APACHEII score 18 and ARDS, combined with shock were independent risk factors for HAP death when infected with Acinetobacter baumannii (Acinetobacter baumannii). Conclusion for patients with ICU, the risk of Acinetobacter baumannii infection should be vigilant in patients with mechanical ventilation history, and the hospitalization days and mechanical ventilation time of ICU should be reduced as much as possible. Clinical abuse of carbapenems increases the risk of Acinetobacter baumannii infection in inpatients. The APACHE 鈪，

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