Related risk factors of carbapenem-resistant Acinetobacter baumannii in second-level general hospitals of Sichuan province

doi:10.3877/cma.j.issn.1674-6902.2020.03.013

Abstract

Abstract:

Objective

To explore the related risk factors of carbapenem-resistant Acinetobacter baumannii in second-level general hospitals of Sichuan province.

Methods

A retrospective case-control study was performed, and the patients with Acinetobacter baumannii infection in the 6 second-level comprehensive hospitals in Sichuan province from January 2015 to January 2016 were selected for this study. According to the drug sensitivity results, the patients were divided into a carbapenem-resistant Acinetobacter baumannii (CRAB) group and a carbapenem-sensitive Acinetobacter baumannii (CSAB) group.

Results

A total of 202 strains of non-repeated Acinetobacter baumannii were collected, among which 90 strains were resistant to carbapenem. The resistance rate of Acinetobacter baumannii to carbapenem was 40.1%. There were four independent risk factors for CRAB infections: urinary catheterization (OR=9.576, 95%CI=4.964~18.474, P=0.000), central venous catheterization (OR=2.707, 95%CI=1.158~6.330, P=0.022), the use of fluoroquinolone (OR=3.869, 95%CI=1.603~9.377, P=0.003), and the application of carbapenem antibiotics (OR=2.755, 95%CI=1.164~6.521, P=0.021).

Conclusion

CRAB occurrence may be related with the invasive procedure and the selection pressure of fluoroquinolone and carbapenem antibiotics in second-level comprehensive hospitals.

Key words: Second-level general hospital, Acinetobacter baumannii, Carbapenem-resistant, Drug resistance, Risk factors

Dongmei Huang, Jun Liu, Fuxiang Li, Li Fan, Yingjie Jing, Xiao Peng and. Related risk factors of carbapenem-resistant Acinetobacter baumannii in second-level general hospitals of Sichuan province[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(03): 355-359.

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危险因素	CRAb(n＝90)	CSAb(n＝112)	P值
年龄(岁)	66.5±15	68.4±13	0.364
女性	22(24.4)	41(36.6)	0.064
糖尿病	15(16.7)	12(10.7)	0.217
脑血管意外	19(21.1)	16(14.3)	0.203
慢性肺部疾病	26(28.9)	35(31.2)	0.716
恶性肿瘤	6(6.7)	15(13.4)	0.120
心脏病	25(27.8)	25(22.3)	0.372
肝功能不全	16(17.8)	7(6.2)	0.010
肾功能不全	14(15.6)	12(10.7)	0.307
低蛋白血症	38(42.2)	26(23.2)	0.004
住院天数(d)	15.6±11	9.2±7	0.000
入住ICU	67(74.4)	30(26.8)	0.000
入住ICU<7 d	22(24.4)	12(10.7)	0.010
入住ICU>7 d	45(50.0)	18(16.1)	0.000
住院超过30 d	12(13.3)	4(3.6)	0.011
择期或急诊手术	23(25.6)	15(13.4)	0.028
中央静脉置管	54(60.0)	19(17.0)	0.000
外科引流	10(11.1)	3(2.7)	0.015
留置尿管	72(80.0)	33(29.5)	0.000
留置胃管	58(64.4)	25(22.3)	0.000
气管切开	7(7.8)	7(6.2)	0.671
机械通气	66(73.3)	28(25.0)	0.000
机械通气<7 d	28(31.1)	17(15.2)	0.007
机械通气>7 d	38(42.2)	11(9.8)	0.000
一、二代头孢类药物的使用	10(11.1)	17(15.2)	0.398
三、四代头孢类药物的使用	37(41.1)	40(35.7)	0.432
β类酰胺酶抑制剂的使用	49(54.4)	56(50.0)	0.530
氟喹诺酮类药物的使用	26(28.9)	12(10.7)	0.001
碳青霉烯类药物的使用	29(32.2)	11(9.8)	0.000
抗菌药物使用天数(d)	11.7±6	8.0±5	0.000

危险因素	CRAb(n＝90)	CSAb(n＝112)	P值
年龄(岁)	66.5±15	68.4±13	0.364
女性	22(24.4)	41(36.6)	0.064
糖尿病	15(16.7)	12(10.7)	0.217
脑血管意外	19(21.1)	16(14.3)	0.203
慢性肺部疾病	26(28.9)	35(31.2)	0.716
恶性肿瘤	6(6.7)	15(13.4)	0.120
心脏病	25(27.8)	25(22.3)	0.372
肝功能不全	16(17.8)	7(6.2)	0.010
肾功能不全	14(15.6)	12(10.7)	0.307
低蛋白血症	38(42.2)	26(23.2)	0.004
住院天数(d)	15.6±11	9.2±7	0.000
入住ICU	67(74.4)	30(26.8)	0.000
入住ICU<7 d	22(24.4)	12(10.7)	0.010
入住ICU>7 d	45(50.0)	18(16.1)	0.000
住院超过30 d	12(13.3)	4(3.6)	0.011
择期或急诊手术	23(25.6)	15(13.4)	0.028
中央静脉置管	54(60.0)	19(17.0)	0.000
外科引流	10(11.1)	3(2.7)	0.015
留置尿管	72(80.0)	33(29.5)	0.000
留置胃管	58(64.4)	25(22.3)	0.000
气管切开	7(7.8)	7(6.2)	0.671
机械通气	66(73.3)	28(25.0)	0.000
机械通气<7 d	28(31.1)	17(15.2)	0.007
机械通气>7 d	38(42.2)	11(9.8)	0.000
一、二代头孢类药物的使用	10(11.1)	17(15.2)	0.398
三、四代头孢类药物的使用	37(41.1)	40(35.7)	0.432
β类酰胺酶抑制剂的使用	49(54.4)	56(50.0)	0.530
氟喹诺酮类药物的使用	26(28.9)	12(10.7)	0.001
碳青霉烯类药物的使用	29(32.2)	11(9.8)	0.000
抗菌药物使用天数(d)	11.7±6	8.0±5	0.000

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