碳青霉烯类耐药鲍曼不动杆菌感染的发生率。
Incidence of infections caused by carbapenem-resistant Acinetobacter baumannii.
机构信息
Laboratory of Molecular Microbiology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Laboratory of Molecular Microbiology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
出版信息
Am J Infect Control. 2019 Dec;47(12):1431-1435. doi: 10.1016/j.ajic.2019.07.009. Epub 2019 Aug 7.
BACKGROUND
Carbapenem-resistant Acinetobacter baumannii (CR-Ab) has become a worrying health care problem, mainly in developing countries, such as Brazil. The objective was to investigate the prevalence and prognostic factors for CR-Ab infections at a Brazilian university hospital and examine the impact of inappropriate antimicrobial therapy on patient outcome.
METHODS
A retrospective study on hospitalized patients with CR-Ab infections was carried out from January 2013 to December 2017. An epidemiologic analysis was carried out to determine the frequency of infections, the epidemiologic indicators by year, the risk factors for 30-day mortality, and the impact of inappropriate therapy.
RESULTS
A total of 489 patients were included in the study. A rate of 0.7 per 1,000 patient-day CR-Ab infections was observed, mostly in the lungs (54.7%), and predominantly in the adult intensive care unit. The occurrence of infections by CR-Ab per 1,000 patient-days in November 2014 exceeded the established control limit, confirming an outbreak.
CONCLUSIONS
The prevalence of CR-Ab increased in the investigated hospital, passing to an endemic pathogen with a direct impact on mortality and the control of these strains.
背景
耐碳青霉烯鲍曼不动杆菌（CR-Ab）已成为一个令人担忧的卫生保健问题，主要在发展中国家，如巴西。本研究的目的是调查巴西某大学附属医院耐碳青霉烯鲍曼不动杆菌感染的流行率和预后因素，并研究不适当抗菌治疗对患者结局的影响。
方法
对 2013 年 1 月至 2017 年 12 月期间住院的耐碳青霉烯鲍曼不动杆菌感染患者进行回顾性研究。进行流行病学分析以确定感染频率、按年份的流行病学指标、30 天死亡率的危险因素以及不适当治疗的影响。
结果
本研究共纳入 489 例患者。耐碳青霉烯鲍曼不动杆菌感染率为 0.7/1000 患者日，主要发生于肺部（54.7%），主要发生于成人重症监护病房。2014 年 11 月耐碳青霉烯鲍曼不动杆菌感染发生率超过既定控制限，确认出现暴发。
结论
本研究医院耐碳青霉烯鲍曼不动杆菌的流行率增加，已成为一种地方性病原体，对死亡率和这些菌株的控制有直接影响。
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