Nosocomial imipenem-resistant Acinetobacter baumannii infections: Epidemiology and risk factors
Nosocomial imipenem-resistant Acinetobacter baumannii infections: Epidemiology and risk factors
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DOI：
10.3109/00365548.2010.489568
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发表时间：
2010-10-01
影响因子：
--
通讯作者：
Hizel, Kenan
中科院分区：
文献类型：
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作者：
Dizbay, Murat;Tunccan, Ozlem Guzel;Hizel, Kenan
回顾性分析2003-2007年5年间医院耐亚胺培南鲍曼不动杆菌（IRAB）感染的发生率、临床特征、危险因素、抗菌药物敏感性和结局。共有720例925例鲍曼不动杆菌感染患者被纳入研究。鲍曼不动杆菌感染主要见于重症监护病房。发病率为6.2‰。最常见的感染是肺炎和血液感染。不动杆菌对亚胺培南的耐药性逐年显著增加（从43.3%增加到72.9%）。死亡率与亚胺培南耐药性、重症监护病房、女性、年龄和肺炎有关。血液透析、恶性肿瘤和机械通气是IRAB感染的重要危险因素。肺炎患者分离的菌株对亚胺培南的耐药性较高。IRAB菌株对其他抗生素的耐药率高于亚胺培南敏感菌株。对鲍曼不动杆菌最有效的抗菌药物是头孢哌酮舒巴坦和奈替米星。鲍曼不动杆菌感染和亚胺培南耐药性在研究期间呈上升趋势。在机械通气和血液透析患者以及恶性肿瘤患者中应考虑IRAB感染。
The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of nosocomial imipenem-resistant A. baumannii (IRAB) infections during a 5-y period (2003-2007) were retrospectively analyzed. A total of 720 patients with 925 episodes of A. baumannii infection were included in the study. A. baumannii infections were seen mostly in intensive care units. The incidence was 6.2 per 1000 admissions. The most common infections were pneumonias and bloodstream infections. Imipenem resistance among Acinetobacter strains increased significantly each y of the study (from 43.3% to 72.9%). Mortality was related to the presence of imipenem resistance, stay in intensive care unit, female gender, old age, and pneumonia. Haemodialysis, malignancy, and mechanical ventilation were significant risk factors for IRAB infections. Imipenem resistance was higher in strains isolated from patients with pneumonia. IRAB strains showed higher resistance rates to other antibiotics than imipenem-susceptible strains. The most active antimicrobial agents against A. baumannii were cefoperazone-sulbactam and netilmicin. The incidence of A. baumannii infections and imipenem resistance increased during the study period. IRAB infections should be considered in patients on mechanical ventilation and haemodialysis and in patients with malignancies.