CAJ | 학술논문

目的：探讨住院患者血流感染耐碳青霉烯类鲍曼不动杆菌（CRAB）的危险因素及预后。方法采用病例对照研究，回顾性收集某院2010—2013年 CRAB 血流感染患者163例，并以同期68例对碳青霉烯类敏感的鲍曼不动杆菌（CSAB）血流感染患者作为对照，进行危险因素及预后分析。结果 CRAB 血流感染的独立危险因素是感染前入住重症监护病房（ICU）[OR 及 OR95％CI ：1．27（5．55～22．89）]及入住过急诊室[OR 及 OR95％CI ：3．57（1．67～7．62）]。鲍曼不动杆菌（AB）血流感染患者28 d 生存率 CRAB 为66．17％，而 CSAB 为96．95％， CRAB 组患者的生存率低于 CSAB 组（χ2＝15．71，P ＜0．001）。影响 AB 血流感染预后的独立危险因素包括感染CRAB（HR95％CI ：3．01～67．28）、血液病（HR95％CI ：3．77～25．97）、心功能不全（HR95％CI ：2．10～20．41）、入住 ICU（HR95％CI ：1．01～5．28）及年龄（HR95％CI：1．01～1．04）。结论感染前入住 ICU 以及入住过急诊室是CRAB 血流感染的危险因素，CRAB 血流感染是影响患者预后的危险因素。
목적：탐토주원환자혈류감염내탄청매희류포만불동간균（CRAB）적위험인소급예후。방법채용병례대조연구，회고성수집모원2010—2013년 CRAB 혈류감염환자163례，병이동기68례대탄청매희류민감적포만불동간균（CSAB）혈류감염환자작위대조，진행위험인소급예후분석。결과 CRAB 혈류감염적독립위험인소시감염전입주중증감호병방（ICU）[OR 급 OR95％CI ：1．27（5．55～22．89）]급입주과급진실[OR 급 OR95％CI ：3．57（1．67～7．62）]。포만불동간균（AB）혈류감염환자28 d 생존솔 CRAB 위66．17％，이 CSAB 위96．95％， CRAB 조환자적생존솔저우 CSAB 조（χ2＝15．71，P ＜0．001）。영향 AB 혈류감염예후적독립위험인소포괄감염CRAB（HR95％CI ：3．01～67．28）、혈액병（HR95％CI ：3．77～25．97）、심공능불전（HR95％CI ：2．10～20．41）、입주 ICU（HR95％CI ：1．01～5．28）급년령（HR95％CI：1．01～1．04）。결론감염전입주 ICU 이급입주과급진실시CRAB 혈류감염적위험인소，CRAB 혈류감염시영향환자예후적위험인소。
Objective To explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii (CRAB).Methods 163 patients with CRAB bloodstream in-fection from 2010 to 2013 were conducted retrospective case-control study,68 patients with bloodstream infection due to carbapenem-susceptible Acinetobacter baumannii (CSAB)during the same period were as control group. Results The independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU)(OR, 1 .27[95%CI ,5.55-22.89])and emergency department(OR,3.57 [95%CI ,1 .67 -7.62])before infection.Pa-tients with CRAB bloodstream infection had lower 28-day survival rate than those with CSAB bloodstream infection (66.17% vs 96.95%,χ2 =15.71 ,P <0.001 ).The independent risk factors for influencing prognosis of Acineto-bacter baumannii bloodstream infection were infection of CRAB (HR 95% CI ,3.01 -67.28),blood disease(HR 95%CI ,3.77-25.97),cardiac insufficiency(HR 95%CI ,2.10-20.41),stay in ICU(HR 95%CI ,1 .01 -5.28), and age(HR 95%CI ,1 .01 -1 .04).Conclusion The independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection,CRAB bloodstream infection is risk factor for influencing prognosis of patients.