我国耐碳青霉烯鲍氏不动杆菌感染医院获得性肺炎影响因素的Meta分析

Meta analysis of risk factors of hospital-acquired pneumonia caused by carbapcnem-resistant Acinetobacter baumannii

  • 摘要: 目的 对我国耐碳青霉烯类鲍氏不动杆菌(CRAB)感染医院获得性肺炎(HAP)的影响因素进行综合评价。方法 检索国内外数据库中2000年1月1日-2017年11月30日发表的关于CRAB感染医院获得性肺炎影响因素的相关文献,选择符合标准的临床资料,用Meta分析的方法对入选文献进行数据提取和综合分析。结果 共17篇文献入选本研究,累计2 340例,对11个影响因素进行分析,其中有7个因素差异具有统计学意义,分别是使用激素(OR=1.89,95%CI=1.47~2.43)、机械通气(OR=4.13,95%CI=3.38~5.05)、深静脉置管(OR=2.11,95%CI=1.40~3.19)、≥3种抗菌药物(OR=3.58,95%CI=2.12~6.06)、使用抗菌药物≥1周(OR=5.13,95%CI=2.62~10.04)、感染前使用碳青霉烯类抗菌药物(OR=5.46,95%CI=3.52~8.46)、入住ICU≥7天(OR=4.84,95%CI=1.54~15.19)。结论 应对国内CRAB感染HAP的影响因素采取针对性措施,减少和预防CRAB感染HAP的发生。

     

    Abstract: OBJECTIVE To synthetically evaluate the risk factors of hospital-acquired pneumonia(HAP) caused by carbapcnem-resistant Acinetobacter baumannii (CRAB) in China. METHODS The relative researches of HAP caused by CRAB were searched by domestic and abroad literature database from Jan. 1,2000 to Nov. 30,2017. The clinical data that conformed to the standard were selected. Data extraction and comprehensive analysis of selected literatures were carried out by meta analysis. RESULTS Totally 17 relative literatures were selected in this study, including 2340 patients. Among eleven risk factors, seven factors had statistical significances, which were using hormone(OR=1.89,95%CI=1.47~2.43),mechanical ventilation(OR=4.13,95%CI=3.38~5.05),using deep venous catheterization(OR=2.11,95%CI=1.40~3.19),use of more than three antibiotics(OR=3.58,95%CI=2.12~6.06),using antibiotics more than a week(OR=5.13,95%CI=2.62~10.04),use of carbapenems antibiotics before the infection(OR=5.46,95%CI=3.52~8.46), and stay in ICU more than 7 days(OR=4.84,95%CI=1.54~15.19). CONCLUSION It is necessary to take effective measures according to the related risk factors so as to reduce and prevent HAP caused by CRAB.

     

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