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伊朗东北部医院获得性碳青霉烯类耐药鲍曼不动杆菌、相关因素及临床结局。

Nosocomial carbapenem-drug resistant Acinetobacter baumannii, related factors and clinical outcomes in Northeast Iran.

机构信息

Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran.

Ischemic Disorders Research Center, Department of Biostatistics and Epidemiology, School of Health, Golestan University of Medical Sciences, Gorgan, Iran.

出版信息

BMC Infect Dis. 2024 Oct 4;24(1):1103. doi: 10.1186/s12879-024-09972-z.

Abstract

BACKGROUND AND OBJECTIVES

Nosocomial infections, including drug-resistant Acinetobacter baumannii infections, continue to impact the health of hospitalized patients. This study sought to determine the prevalence of these infections and assess the associated risk factors and clinical outcomes in Gorgan, Iran.

METHODS

A retrospective cross-sectional study was conducted on 143 infected patients with Acinetobacter baumannii in two educational hospitals in Gorgan city, Iran between 2016 and 2018. Patient information including age, gender, reason and duration of hospitalization, background of diseases, type of sample culture, symptoms, laboratory findings, prescribed antibiotics, and antibiogram were collected and analyzed. The Logistic regression and survival statistical methods were used by software of SPSS 26.

RESULTS

A total of 37 patients (25.87%) died during hospitalization. The less than one year and 45-65 years age groups demonstrated more deaths (29.7%; p-value < 0.001). Being single (not being married) was found to be a risk factor in increasing the chance of death among patients (OR = 2.154, 95% CI: 1.02-4.53; p = 0.048). Hospitalization in intensive care units (ICUs) was a risk factor for the death of patients (OR = 4.655, 95% CI: 7.6-83.2). The resistance to carbapenems was reported to be an important risk factor for the death of patients.

CONCLUSIONS

Acinetobacter baumannii infections, particularly those resistant to carbapenems, are a significant risk for patients in ICUs and can lead to higher mortality rates.

摘要

背景与目的

医院感染(包括耐碳青霉烯鲍曼不动杆菌感染)持续影响住院患者的健康。本研究旨在确定这些感染在伊朗戈尔甘的流行情况,并评估相关的危险因素和临床结局。

方法

回顾性横断面研究于 2016 年至 2018 年在伊朗戈尔甘市的两所教学医院对 143 例感染鲍曼不动杆菌的患者进行。收集并分析患者的信息,包括年龄、性别、住院原因和时间、疾病背景、样本培养类型、症状、实验室发现、所开抗生素和药敏试验结果。采用 SPSS 26 软件进行 Logistic 回归和生存统计分析。

结果

共有 37 例(25.87%)患者在住院期间死亡。1 年以下和 45-65 岁年龄组的死亡率更高(29.7%;p 值<0.001)。单身(未婚)被发现是增加患者死亡几率的危险因素(OR=2.154,95%CI:1.02-4.53;p=0.048)。入住重症监护病房(ICU)是患者死亡的危险因素(OR=4.655,95%CI:7.6-83.2)。对碳青霉烯类药物的耐药性被报道是患者死亡的重要危险因素。

结论

鲍曼不动杆菌感染,特别是对碳青霉烯类药物耐药的感染,对 ICU 中的患者是一个重大风险,可能导致更高的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d078/11451023/7480659a0994/12879_2024_9972_Fig1_HTML.jpg

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