【摘要】 目的探讨外科术后耐碳青霉烯类抗菌药物鲍曼不动杆菌(CRAB)感染的危险因素。方法选择161例外科手术后检出鲍曼不动杆菌患者,采用单因素及多因素Logistic回归分析外科术后感染CRAB危险因素。结果与碳青霉烯类抗菌药物敏感鲍曼不动杆菌(CSAB)组患者相比,CRAB组患者的年龄较高,术前有基础疾病、入住ICU、有气管切开、无心脏反搏、有应用碳青霉烯类抗菌药物者比例较高、应用呼吸机时间较长(P均<0.05)。进一步多因素Logistic分析显示,年龄、术前有无基础疾病、有无入住ICU、呼吸机的应用时间、有无气管切开以及有无应用碳青霉烯类抗菌药物与外科术后CRAB感染的发生有关(P均<0.05)。结论对于高龄、术前有基础疾病、有入住ICU、应用呼吸机时间较长、行气管切开、有应用碳青霉烯类抗菌药物者应在进行外科手术前合理干预,术中、术后合理处置,以降低术后CRAB感染率。更多还原

【Abstract】 Objective To investigate the risk factors of surgical infection by carbapenem-resistant Acinetobacter baumannii(CRAB). Methods A total of 161 patients infected by CRAB after surgery were selected. The risk factors of CRAB infection were analyzed by using the univariate and multivariate logistic regression analyses. Results Compared with patients with carbapenem-sensitive Acinetobacter baumannii(CSAB), CRAB counterparts were older, had a significantly higher percentage of preoperative basic diseases, intensive care unit(ICU) stay, tracheotomy, no cardiac counterpulsation, and use of carnapenem antibiotics and required a longer period of ventilator(all P < 0.05). Multivariate analysis demonstrated that age, preoperative basic diseases, ICU stay, time of ventilator usage, tracheotomy and use of carnapenem antibiotics were significantly correlated with postoperative CRAB infection(all P < 0.05). Conclusion Rational preoperative intervention, effective intraoperative and postoperative management should be implemented to reduce the postoperative risk of CRAB infection for elderly patients with preoperative basic diseases, ICU stay, long time of ventilator usage, tracheotomy and use of carnapenem antibiotics.更多还原