加護病房Acinetobacter baumannii醫療照護相關感染之影響因素

Factors Influencing Healthcare-associated Infections with Acinetobacter baumannii at Intensive Care Units

陳瑛瑛(Yin-Yin Chen) ； 王復德(Fu-Der Wang)

《感染控制雜誌》 20卷6期 (2010/12) Pp. 377-387

https://doi.org/10.6526/ICJ.201012_20(6).0003

摘要

The purpose of this prospective study was to detect the factors influencing healthcare-associated infections (HAIs) with Acinetobacter baumannii in intensive care units (ICUs). All the patients admitted to the ICUs in a medical center from 2007 to 2008 were eligible for the study. Patients who spent less than 2 days in the ICUs were excluded from the study. Results: A total of 68 patients were diagnosed with A. baumannii HATs. The incidence density was 3.4. Among the diagnosed patients, the rate of imipenem resistance was 14.7%. The most common infection sites were the respiratory tract (39.7%), followed by the bloodstream (30.9%), urinary tract (13.2%), surgical site (11.8%), and others (4.5%). The covariates in logistic regression analysis were adjusted, and the age (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.01-1.05); length of stay in the ICU before HAI (OR, 1.02; 95% CI, 1.01-1.06); antibiotics administered before admission to the ICU (OR, 2.28; 95% CI, 1.26-4.11); and the use of mechanical ventilators (OR, 13.82; 95% CI, 5.25-29.39), urinary catheters (OR, 6.77; 95% CI, 3.1-14.78), and nasogastric tubes (OR, 11.61; 95% CI, 3.63-29.19) were determined as independent risk factors. Conclusions: The most common A. baumannii HAIs were the respiratory tract infections. Good infection control practices, especially good care of catheter- associated equipment, may be an important strategy for preventing infections with A. baumannii and their spread in the hospital.

關鍵字

鮑氏不動桿菌 ； 醫療照護相關感染 ； 加護病房

並列摘要

The purpose of this prospective study was to detect the factors influencing healthcare-associated infections (HAIs) with Acinetobacter baumannii in intensive care units (ICUs). All the patients admitted to the ICUs in a medical center from 2007 to 2008 were eligible for the study. Patients who spent less than 2 days in the ICUs were excluded from the study. Results: A total of 68 patients were diagnosed with A. baumannii HATs. The incidence density was 3.4. Among the diagnosed patients, the rate of imipenem resistance was 14.7%. The most common infection sites were the respiratory tract (39.7%), followed by the bloodstream (30.9%), urinary tract (13.2%), surgical site (11.8%), and others (4.5%). The covariates in logistic regression analysis were adjusted, and the age (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.01-1.05); length of stay in the ICU before HAI (OR, 1.02; 95% CI, 1.01-1.06); antibiotics administered before admission to the ICU (OR, 2.28; 95% CI, 1.26-4.11); and the use of mechanical ventilators (OR, 13.82; 95% CI, 5.25-29.39), urinary catheters (OR, 6.77; 95% CI, 3.1-14.78), and nasogastric tubes (OR, 11.61; 95% CI, 3.63-29.19) were determined as independent risk factors. Conclusions: The most common A. baumannii HAIs were the respiratory tract infections. Good infection control practices, especially good care of catheter- associated equipment, may be an important strategy for preventing infections with A. baumannii and their spread in the hospital.

並列關鍵字

Acinetobacter baumannii healthcare-associated infection ； intensive care unit