多重耐药鲍曼不动杆菌血流感染患者临床特点和预后回顾性分析

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Abstract Objective To analyze the clinical manifestations and risk factors of patients with bloodstream infections (BSI) caused by multi-drug resistant Acinetobacter baumannii (MDR-AB). Methods Clinical data of patients with BSI caused by MDR-AB hospitalized in Chinese PLA General Hospital from January 2012 to December 2015 were analyzed retrospectively. According to the 14-day survival after diagnosis, the patients were divided into survival group and death group. The risk factors of death were investigated by single-factor analysis and multifactor Logistic regression analysis. Results Among the 157 patients, 55.4% were collected from ICU, and the 14-day mortality was 54.8%. Single-factor analysis showed that the survival group was significantly lower than the death group in malignancy, immunosuppressive therapy, neutropenia,ventilator use and Pitt Bacteremia Score (PBS), with statistically significant difference (P < 0.05). And the survival group was significantly higher than the death group in appropriate therapy and treatment with Sulbactam, with statistically significant difference (P < 0.05). Multifactor Logistic regression analysis showed malignancy (OR=4.78, 95%CI: 1.30-15.32, P < 0.05), neutropenia (OR=16.01, 95%CI: 1.64-172.21, P < 0.05) and increased PBS (OR=0.47, 95%CI: 0.32-0.63, P < 0.05) were independent risk factors of 14-day mortality. Patients with hematological malignancies were often accompanied with neutropenia, and the survival analysis revealed that mortality in patients with hematological malignancies was higher than that in patients with solid tumors (P < 0.05).The percentage of patients treated with antibiotics containing Sulbactam in the survival group was significantly higher than that in the death group (P < 0.05), but it was not revealed as a death protection factor in multivariate analysis. Conclusion The patients with BSI caused by MDR-AB usually have serious sunder lying diseases from ICU, and the mortality is quite high. Malignancy, neutropenia and increased PBS are independent risk factors of early mortality. Antimicrobial regimens containing Sulbactam may be a candidate for the treatment of BSI caused by MDR-AB, but its clinical efficacy deserves further exploration.

Key words： Bloodstream infection Multidrug-resistant Acinetobacter baumannii Risk factors Prognosis

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	ZHOU Ting* LIANG Xiuting* WU Jie

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ZHOU Ting* LIANG Xiuting* WU Jie. A retrospective analysis of clinical features and prognostic of patients with bloodstream infections caused by multi-drug resistant Acinetobacter baumannii[J]. 中国医药导报, 2017, 14(31): 60-63.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I31/60

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