耐碳青霉烯类鲍曼不动杆菌血流感染危险因素的Meta分析

Meta-analysis of risk factors for carbapenem-resistant Acinetobacter baumannii bloodstream infections

    摘要
  • 摘要:
    目的 系统评价耐碳青霉烯类鲍曼不动杆菌(CRAB)血流感染的危险因素, 为临床感染防控提供循证依据。
    方法 通过计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Cochrane Library数据库, 采用人工与文献追踪相结合的方式, 查询时间范围为建库至2024年8月1日。筛选相关文献, 收集CRAB血流感染危险因素的相关数据, 进行质量评价, 并使用Revman 5.4软件以及stata 17软件对其进行Meta分析, 同时对各因素的异质性和敏感性进行验证。
    结果 本研究最终纳入17篇文献, 中文文献11篇, 英文文献6篇, 共涉及3 275例样本。Meta分析结果显示与CRAB血流感染相关的危险因素有10项：使用碳青霉烯类药物、入住重症监护室(ICU)、合并感染性休克、有创机械通气、留置尿管、消化道置管、深静脉置管、低蛋白血症、发病前使用激素和男性。
    结论 临床上可针对本研究获得的10项危险因素制定针对性的干预策略, 预防及减少CRAB血流感染的发生。

     

    Abstract:
    OBJECTIVE To systematically evaluate the risk factors for carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection, and to provide evidence-based basis for the prevention and control of healthcare-associated infection.
    METHODS The databases of CNKI, Wanfang, VIP, CBM, PubMed, Web of Science and Cochrane Library were searched by the combination of manual and literature tracking. Relevant literatures ranged from the establishment of the database to Aug. 1, 2024 were screened, risk factors were collected, and quality evaluation was performed. Meta-analysis was performed by Revman5.4 and Stata17 software, and the heterogeneity and sensitivity were verified.
    RESULTS This study finally included 17 articles (11 Chinese and 6 English), involving a total of 3275 samples. Meta-analysis showed that 10 risk factors were associated with CRAB bloodstream infection: use of carbapenems, admission to intensive care unit (ICU), combined with septic shock, invasive mechanical ventilation, indwelling urinary, gastrointestinal and deep venous catheterization, hypoproteinemia, use of hormones before onset of infection and male.
    CONCLUSION Targeted intervention strategies in clinical practice can be formulated for the 10 risk factors in this study to prevent and reduce the occurrence of CRAB bloodstream infection.

     

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