先前入住重症监护病房的患者感染鲍曼不动杆菌是随后发生呼吸机相关性肺炎病例的独立危险因素。
Acinetobacter baumannii infection in prior ICU bed occupants is an independent risk factor for subsequent cases of ventilator-associated pneumonia.
作者信息
Tsakiridou Eirini, Makris Demosthenes, Daniil Zoe, Manoulakas Efstratios, Chatzipantazi Vasiliki, Vlachos Odysseas, Xidopoulos Grigorios, Charalampidou Olympia, Zakynthinos Epaminondas
机构信息
Department of Critical Care Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
Department of Respiratory Medicine, University Hospital of Larisa and School of Medicine, University of Thessaly, Biopolis, 41000 Larisa, Greece.
出版信息
Biomed Res Int. 2014;2014:193516. doi: 10.1155/2014/193516. Epub 2014 Jul 2.
OBJECTIVE
We aimed to evaluate risk factors for ventilator-associated pneumonia (VAP) due to Acinetobacter baumannii (AbVAP) in critically ill patients.
METHODS
This was a prospective observational study conducted in an intensive care unit (ICU) of a district hospital (6 beds). Consecutive patients were eligible for enrolment if they required mechanical ventilation for >48 hours and hospitalization for >72 hours. Clinical, microbiological, and laboratory parameters were assessed as risk factors for AbVAP by univariate and multivariate analysis.
RESULTS
193 patients were included in the study. Overall, VAP incidence was 23.8% and AbVAP, 11.4%. Previous hospitalization of another patient with Acinetobacter baumannii infection was the only independent risk factor for AbVAP (OR (95% CI) 12.016 (2.282-19.521) P < 0.001). ICU stay (25 ± 17 versus 12 ± 9 P < 0.001), the incidence of other infections (OR (95% CI) 9.485 (1.640-10.466) P = 0.002) (urinary tract infection, catheter related infection, and bacteremia), or sepsis (OR (95% CI) 10.400 (3.749-10.466) P < 0.001) were significantly increased in patients with AbVAP compared to patients without VAP; no difference was found with respect to ICU mortality.
CONCLUSION
ICU admission or the hospitalization of patients infected by Acinetobacter baumannii increases the risk of AbVAP by subsequent patients.
目的
我们旨在评估重症患者中鲍曼不动杆菌所致呼吸机相关性肺炎（AbVAP）的危险因素。
方法
这是一项在一家区级医院（6张床位）的重症监护病房（ICU）进行的前瞻性观察性研究。连续入选的患者需满足机械通气超过48小时且住院超过72小时。通过单因素和多因素分析评估临床、微生物学和实验室参数作为AbVAP的危险因素。
结果
193例患者纳入研究。总体而言，VAP发生率为23.8%，AbVAP为11.4%。另一名鲍曼不动杆菌感染患者的既往住院史是AbVAP的唯一独立危险因素（OR（95%CI）12.016（2.282 - 19.521）P < 0.001）。与无VAP的患者相比，AbVAP患者的ICU住院时间（25±17天对12±9天，P < （此处原文有误，推测应为P < 0.001））、其他感染（OR（95%CI）9.485（1.640 - 10.466）P = 0.002）（尿路感染、导管相关感染和菌血症）或脓毒症（OR（95%CI）10.400（3.749 - 10.466）P < 0.001）显著增加；在ICU死亡率方面未发现差异。
结论
ICU收治或鲍曼不动杆菌感染患者的住院会增加后续患者发生AbVAP的风险。
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