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首页|期刊导航|中国感染控制杂志|鲍曼不动杆菌无菌体液感染患者归因危险度多中心回顾性队列研究

鲍曼不动杆菌无菌体液感染患者归因危险度多中心回顾性队列研究OACSTPCD

A multicenter retrospective cohort study on the attributable risk of patients with Acinetobacter baumannii sterile body fluid infection

中文摘要英文摘要

目的 调查重症患者感染鲍曼不动杆菌(AB)后的归因危险度(AR).方法 围绕成人重症监护病房(ICU)患者开展多中心回顾性队列研究.以各中心从无菌体液中分离出AB且确认AB感染患者为感染组,以同期、同一 ICU、相似的急性生理与慢性健康评分Ⅱ(APACHE Ⅱ)评分(±5分)和入住ICU的主要诊断为匹配条件,按1:2比例选取未感染AB患者作为非感染组,计算AR.结果 AB无菌体液感染患者住院病死率为33.3%,非感染组患者为23.1%,两组数据比较,差异无统计学意义(P=0.069),AR为10.2%(95%CI:-2.3%~22.8%).血、脑脊液等标本来源的感染组和非感染组患者病死率比较,差异无统计学意义(P>0.05).主要诊断为肺部感染的重症患者感染AB后AR最高,但感染组和非感染组患者病死率比较,差异无统计学意义(P>0.05),其他诊断分类同样如此.结论 重症患者AB感染预后被严重高估,但ICU仍应针对AB进行积极医院感染控制.

Objective To investigate the attributable risk(AR)of Acinetobacter baumannii(AB)infection in criti-cally ill patients.Methods A multicenter retrospective cohort study was conducted among adult patients in inten-sive care unit(ICU).Patients with AB isolated from sterile body fluid and confirmed with AB infection in each cen-ter were selected as the infected group.According to the matching criteria that patients should be from the same pe-riod,in the same ICU,as well as with similar APACHE Ⅱ score(±5 points)and primary diagnosis,patients who did not infect with AB were selected as the non-infected group in a 1:2 ratio.The AR was calculated.Results The in-hospital mortality of patients with AB infection in sterile body fluid was 33.3%,and that of non-infected group was 23.1%,with no statistically significant difference between the two groups(P=0.069).The AR was 10.2%(95%CI:-2.3%-22.8%).There is no statistically significant difference in mortality between non-infected pa-tients and infected patients from whose blood,cerebrospinal fluid and other specimen sources AB were isolated(P>0.05).After infected with AB,critically ill patients with the major diagnosis of pulmonary infection had the high-est AR.There was no statistically significant difference in mortality between patients in the infected and non-infec-ted groups(P>0.05),or between other diagnostic classifications.Conclusion The prognosis of AB infection in critically ill patients is highly overestimated,but active healthcare-associated infection control for AB in the ICU should still be carried out.

何磊;夏琴;何莉;刘晞照;舒昌惠;李荣琴;陶红英;陈泽芬;姜道彬;刘丁;郑小芳;邱荷语;吴淑梅;吴晓英;崔金兰;谢首佳

重庆市大足区人民医院感染控制科,重庆 402360重庆市南川区人民医院院感科,重庆 408400成都市蒲江县人民医院感染管理科,四川成都 611630重庆大学附属三峡医院感染管理科,重庆 404000重庆市璧山区人民医院感染管理科,重庆 402760重庆市綦江区人民医院感染管理科,重庆 401420重庆市长寿区人民医院感染管理科,重庆 401220重庆大学附属江津医院感染管理科,重庆 402260陆军军医大学陆军特色医学中心疾病预防控制科,重庆 400042重庆大学附属涪陵医院感染管理科,重庆 408099重庆医科大学附属永川医院感染管理科,重庆 402160重庆市秀山县人民医院感染管理科,重庆 409999重庆市开州区人民医院感染管理科,重庆 405400

预防医学

鲍曼不动杆菌归因危险度预后无菌体液多中心队列研究

Acinetobacter baumanniiattributable riskprognosissterile body fluidbloodmulticenter cohort study

《中国感染控制杂志》 2024 (001)

42-48 / 7

重庆市卫生计生委重点项目(20141024)

10.12138/j.issn.1671-9638.20243007

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