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临床影响单一克隆(序列类型 92)多重耐药鲍曼不动杆菌在重症监护病房。

Clinical impacts of a single clone (sequence type 92) of multidrug-resistant Acinetobacter baumannii in intensive care units.

机构信息

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, South Korea.

出版信息

Microb Drug Resist. 2011 Dec;17(4):559-62. doi: 10.1089/mdr.2011.0087. Epub 2011 Aug 10.

Abstract

The clinical outcomes of patients infected with a single clone of an multidrug-resistant (MDR) strain of Acinetobacter baumannii were investigated. A matched comparative cohort study was conducted in a tertiary hospital in Korea. Thirty patients infected with single clone of MDR A. baumannii admitted to two intensive care units (ICUs) were matched to 30 control patients without A. baumannii, while controlling for concomitant diseases and severity of illness. All analyzed MDR A. baumannii isolates were identified as sequence type (ST) 92. In-hospital and in-ICU mortality rates did not differ significantly between the cases and controls (p=0.795 vs. p=0.796). Multivariate analysis demonstrated that MDR A. baumannii ST92 infection was the independent risk factor for prolonged hospital stay (odds ratio [OR] 13.12, 95% confidence interval [CI] 3.06-56.19, p=0.001), prolonged ICU stay (OR 9.66, 95% CI 2.73-34.13, p<0.001), and prolonged mechanical ventilation (OR 8.63, 95% CI 2.21-33.68, p=0.002). These findings indicate that MDR A. baumannii ST92 infection results in adverse outcomes of patients, and strict adherence to infection controls in ICUs should be encouraged.

摘要

对感染单一克隆耐多药(MDR)鲍曼不动杆菌菌株的患者的临床结局进行了研究。在韩国的一家三级医院进行了一项匹配的对照队列研究。将入住 2 个重症监护病房(ICUs)的 30 例感染单一克隆 MDR 鲍曼不动杆菌的患者与 30 例无鲍曼不动杆菌的对照患者相匹配,同时控制伴随疾病和疾病严重程度。所有分析的 MDR 鲍曼不动杆菌分离株均被鉴定为序列型(ST)92。病例组和对照组的院内和 ICU 死亡率无显著差异(p=0.795 对比 p=0.796)。多变量分析表明,MDR 鲍曼不动杆菌 ST92 感染是延长住院时间(优势比[OR]13.12,95%置信区间[CI]3.06-56.19,p=0.001)、延长 ICU 入住时间(OR 9.66,95%CI 2.73-34.13,p<0.001)和延长机械通气时间(OR 8.63,95%CI 2.21-33.68,p=0.002)的独立危险因素。这些发现表明,MDR 鲍曼不动杆菌 ST92 感染导致患者结局不良,应鼓励 ICU 严格遵守感染控制措施。

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