基于临床资料对鲍曼不动杆菌院内感染患者预后不良危险因素的回顾性分析

Retrospective Analysis of Risk Factors for Poor Prognosis in Patients with Nosocomial Acinetobacter baumannii Infection Based on Clinical Data

摘要: 目的：观察我院2024年1月~12月鲍曼不动杆菌院内感染分布情况及对应患者的临床信息，分析其发生预后不良的危险因素，探究有效预防院内感染的方法。方法：使用回顾性调查研究方法，选取我院2024年1月至12月期间鲍曼不动杆菌院内感染121例，收集对应患者的临床信息，分别采用cox回归分析和logistics回归分析发现鲍曼不动杆菌医院感染预后不良及耐碳青霉烯类鲍曼不动杆菌感染的独立危险因素。结果：多因素cox回归分析结果显示：高龄、碳青霉烯类耐药、肺部疾病、抗生素使用 > 14天、呼吸机使用是发生AB院内感染预后不良的独立危险因素；多因素logistics回归分析结果显示：ICU住院史及时长、动静脉置管及留置胃管是CRAB感染的独立危险因素(P < 0.05)。结论：高龄、部分基础疾病及有创操作、抗生素的不当使用是鲍曼不动杆菌院内感染及预后不良的独立危险因素。临床工作者应当严格指征、规范使用抗生素和有创操作，以期降低AB院内感染风险，提高患者生存率。

Abstract: Objective: To observe the distribution of nosocomial Acinetobacter baumannii infections and the clinical information of corresponding patients in our hospital from January to December 2024, analyze the risk factors for poor prognosis, and explore effective methods for preventing nosocomial infections. Methods: A retrospective survey method was used. A total of 121 cases of nosocomial Acinetobacter baumannii infections in our hospital from January to December 2024 were selected, and the clinical information of the corresponding patients was collected. Cox regression analysis and logistic regression analysis were used respectively to identify the independent risk factors for poor prognosis of Acinetobacter baumannii (AB) nosocomial infection and carbapenem-resistant Acinetobacter baumannii (CRAB) infection. Results: Multivariate Cox regression analysis showed that advanced age, carbapenem resistance, underlying lung disease, antibiotic use > 14 days, and ventilator use were independent risk factors for poor prognosis of AB nosocomial infection. Multivariate logistic regression analysis revealed that history of ICU stay, length of ICU stay, arteriovenous catheterization, and indwelling gastric tube were independent risk factors for CRAB infections (P < 0.05). Conclusion: Advanced age, certain underlying diseases, invasive procedures, and inappropriate use of antibiotics are independent risk factors for nosocomial Acinetobacter baumannii infections and poor prognosis. Clinical workers should strictly adhere to indications and standardize the use of antibiotics and invasive procedures to reduce the risk of nosocomial AB infections and improve patient survival rates.