학술논문
鲍曼不动杆菌无菌体液感染患者归因危险度多中心回顾性队列研究 / A multicenter retrospective cohort study on the attributable risk of patients with Acinetobacter baumannii sterile body fluid infection
Document Type
Academic Journal
Author
何磊; 姜道彬; 刘丁; 郑小芳; 邱荷语; 吴淑梅; 吴晓英; 崔金兰; 谢首佳; 夏琴; 何莉; 刘晞照; 舒昌惠; 李荣琴; 陶红英; 陈泽芬; HE Lei; JIANG Dao-bin; LIU Ding; ZHENG Xiao-fang; QIU He-yu; WU Shu-mei; WU Xiao-ying; CUI Jin-lan; XIE Shou-jia; XIA Qin; HE Li; LIU Xi-zhao; SHU Chang-hui; LI Rong-qin; TAO Hong-ying; CHEN Ze-fen
Source
中国感染控制杂志 / Chinese Journal of Infection Control. 23(1):42-48
Subject
Language
Chinese
ISSN
1671-9638
Abstract
目的 调查重症患者感染鲍曼不动杆菌(AB)后的归因危险度(AR).方法 围绕成人重症监护病房(ICU)患者开展多中心回顾性队列研究.以各中心从无菌体液中分离出AB且确认AB感染患者为感染组,以同期、同一 ICU、相似的急性生理与慢性健康评分Ⅱ(APACHE Ⅱ)评分(±5分)和入住ICU的主要诊断为匹配条件,按1:2比例选取未感染AB患者作为非感染组,计算AR.结果 AB无菌体液感染患者住院病死率为33.3％,非感染组患者为23.1％,两组数据比较,差异无统计学意义(P=0.069),AR为10.2％(95％CI:-2.3％～22.8％).血、脑脊液等标本来源的感染组和非感染组患者病死率比较,差异无统计学意义(P＞0.05).主要诊断为肺部感染的重症患者感染AB后AR最高,但感染组和非感染组患者病死率比较,差异无统计学意义(P＞0.05),其他诊断分类同样如此.结论 重症患者AB感染预后被严重高估,但ICU仍应针对AB进行积极医院感染控制.
Objective To investigate the attributable risk(AR)of Acinetobacter baumannii(AB)infection in criti-cally ill patients.Methods A multicenter retrospective cohort study was conducted among adult patients in inten-sive care unit(ICU).Patients with AB isolated from sterile body fluid and confirmed with AB infection in each cen-ter were selected as the infected group.According to the matching criteria that patients should be from the same pe-riod,in the same ICU,as well as with similar APACHE Ⅱ score(±5 points)and primary diagnosis,patients who did not infect with AB were selected as the non-infected group in a 1:2 ratio.The AR was calculated.Results The in-hospital mortality of patients with AB infection in sterile body fluid was 33.3％,and that of non-infected group was 23.1％,with no statistically significant difference between the two groups(P=0.069).The AR was 10.2％(95％CI:-2.3％-22.8％).There is no statistically significant difference in mortality between non-infected pa-tients and infected patients from whose blood,cerebrospinal fluid and other specimen sources AB were isolated(P＞0.05).After infected with AB,critically ill patients with the major diagnosis of pulmonary infection had the high-est AR.There was no statistically significant difference in mortality between patients in the infected and non-infec-ted groups(P＞0.05),or between other diagnostic classifications.Conclusion The prognosis of AB infection in critically ill patients is highly overestimated,but active healthcare-associated infection control for AB in the ICU should still be carried out.
Objective To investigate the attributable risk(AR)of Acinetobacter baumannii(AB)infection in criti-cally ill patients.Methods A multicenter retrospective cohort study was conducted among adult patients in inten-sive care unit(ICU).Patients with AB isolated from sterile body fluid and confirmed with AB infection in each cen-ter were selected as the infected group.According to the matching criteria that patients should be from the same pe-riod,in the same ICU,as well as with similar APACHE Ⅱ score(±5 points)and primary diagnosis,patients who did not infect with AB were selected as the non-infected group in a 1:2 ratio.The AR was calculated.Results The in-hospital mortality of patients with AB infection in sterile body fluid was 33.3％,and that of non-infected group was 23.1％,with no statistically significant difference between the two groups(P=0.069).The AR was 10.2％(95％CI:-2.3％-22.8％).There is no statistically significant difference in mortality between non-infected pa-tients and infected patients from whose blood,cerebrospinal fluid and other specimen sources AB were isolated(P＞0.05).After infected with AB,critically ill patients with the major diagnosis of pulmonary infection had the high-est AR.There was no statistically significant difference in mortality between patients in the infected and non-infec-ted groups(P＞0.05),or between other diagnostic classifications.Conclusion The prognosis of AB infection in critically ill patients is highly overestimated,but active healthcare-associated infection control for AB in the ICU should still be carried out.