医院获得性肺炎插管患者鲍曼不动杆菌感染的危险因素

Risk factors for infection by Acinetobacter baumannii in intubated patients with nosocomial pneumonia.

作者信息

Baraibar J, Correa H, Mariscal D, Gallego M, Vallés J, Rello J

机构信息

Pulmonary and Critical Care Department, Hospital Italiano, Montevideo, Uruguay.

出版信息

Chest. 1997 Oct;112(4):1050-4. doi: 10.1378/chest.112.4.1050.

DOI:10.1378/chest.112.4.1050

PMID:9377916

Abstract

STUDY OBJECTIVE

To investigate the epidemiology of infection by Acinetobacter baumannii in patients with ventilator-associated pneumonia (VAP).

DESIGN

Prospective clinical study.

SETTING

Three medical-surgical ICUs in teaching hospitals.

PATIENTS

We followed up 707 mechanically ventilated patients and 148 episodes of VAP with etiologic diagnosis.

RESULTS

A baumannii was isolated in 12 (8.1%) episodes in 148 patients. Five of these episodes were directly responsible for death. Using logistic regression analysis, the risk of VAP due to A baumannii was found to be high in patients with neurosurgery (odds ratio [OR]=10.03; 95% confidence interval [CI]=1.55 to 64.90), ARDS (OR=9.73; 95% CI=1.60 to 59.24), head trauma (OR=5.17; 95% CI=0.88 to 30.34), and large-volume pulmonary aspiration (OR=2.90; 95% CI=0.80 to 10.53).

CONCLUSIONS

Intubated patients who develop pneumonia and have any of the above factors are at an increased risk of Acinetobacter infection.

摘要

研究目的

调查鲍曼不动杆菌在呼吸机相关性肺炎（VAP）患者中的感染流行病学。

设计

前瞻性临床研究。

地点

教学医院的三个内科-外科重症监护病房。

患者

我们对707例机械通气患者和148例有病因诊断的VAP发作进行了随访。

结果

在148例患者的12次发作（8.1%）中分离出鲍曼不动杆菌。其中5次发作直接导致死亡。使用逻辑回归分析，发现神经外科患者（比值比[OR]=10.03；95%置信区间[CI]=1.55至64.90）、急性呼吸窘迫综合征（ARDS）患者（OR=9.73；95%CI=1.60至59.24）、头部创伤患者（OR=5.17；95%CI=0.88至30.34）和大量肺误吸患者（OR=2.90；95%CI=0.80至10.53）发生鲍曼不动杆菌所致VAP的风险较高。