Department of Medical Intensive Care Unit, Gazi University School of Medicine, Besevler 06510 Ankara, Turkey.
Department of Medical Intensive Care Unit, Gazi University School of Medicine, Besevler 06510 Ankara, Turkey.
J Crit Care. 2011 Oct;26(5):460-467. doi: 10.1016/j.jcrc.2011.04.007. Epub 2011 Jun 28.
We investigated the characteristics of Acinetobacter baumannii infection in critically ill patients with hematologic malignancies.
The prospectively collected data of patients with hematologic malignancies admitted to a medical intensive care unit of a university hospital from 2007 through 2010 were reviewed retrospectively.
One hundred twenty-eight patients were included in the study, among whom 35 (27%) developed 39 A baumannii infections. Pneumonia was the most common infection site of A baumannii. Presence of neutropenia, underlying hematologic malignancy, and the disease status did not affect the acquisition of the infection. Advancing age, prior exposure to aminoglycosides, central venous catheterization, and presence of nasogastric tube were the independent risk factors for the development of A baumannii infections. The mortality rate was higher in patients with A baumannii infections compared with the ones without (P = .009). However, in multivariate analysis, low Glasgow coma scale, prior immunosuppressive treatment, neutropenia, invasive mechanical ventilation, and severe sepsis were independently associated with mortality, whereas presence of A baumannii infection was not.
Despite the high mortality rate in critically ill patients with hematologic malignancies, presence of A baumannii infection was not an independent risk factor for mortality.
我们研究了血液恶性肿瘤重症患者中鲍曼不动杆菌感染的特征。
回顾性分析了 2007 年至 2010 年期间入住一家大学医院内科重症监护病房的血液恶性肿瘤患者的前瞻性收集数据。
本研究共纳入 128 例患者,其中 35 例(27%)发生 39 例鲍曼不动杆菌感染。肺炎是鲍曼不动杆菌最常见的感染部位。中性粒细胞减少症、基础血液病和疾病状态并不影响感染的发生。年龄增长、先前接触氨基糖苷类药物、中心静脉置管和鼻胃管的存在是鲍曼不动杆菌感染发展的独立危险因素。与无鲍曼不动杆菌感染的患者相比,感染鲍曼不动杆菌的患者死亡率更高(P =.009)。然而,在多变量分析中,格拉斯哥昏迷评分低、先前免疫抑制治疗、中性粒细胞减少症、有创机械通气和严重脓毒症与死亡率独立相关,而鲍曼不动杆菌感染并非如此。
尽管血液恶性肿瘤重症患者的死亡率较高,但鲍曼不动杆菌感染不是死亡的独立危险因素。