OBJECTIVE To explore the risk factors for hospital-acquired pneumonia caused by carbapenem resistant Acinetobacter baumannii (CRAB) in elderly patients in ICU, and to provide references for further improvement of infection prevention and control strategies of CRAB.
METHODS One hundred and eleven elderly patients admitted to the ICU of Changzhou No. 904 Hospital from Jan. 2022 to Mar. 2024 were divided into the infected group (n=34) and uninfected group (n=77) based on whether or not having CRAB hospital-acquired pneumonia, and the risk factors for CRAB hospital-acquired pneumonia in elderly patients were summarized.
RESULTS Univariate analysis showed that patients in the CRAB-infected group had a higher frequemisis of hospitalizations, usage of antimicrobials prior to CRAB detection (within 90 days), persistent fever for 48 hours, and invasive ventilator usage than those in the uninfected group, while albumin levels were lower than those in the uninfected group; Multivariate logistic regression analysis showed that hospitalization frequency (OR=1.240, 95% CI: 1.059-1.452, P=0.007), usage of antibiotics prior to CRAB detection (within 90 days) (OR=2.472, 95% CI: 1.124-5.437, P=0.024), were risk factors for CRAB hospital-acquired pneumonia in elderly hospitalized patients of ICU, and albumin level (OR=0.844, 95% CI: 0.744-0.957, P=0.008) was protective factor for CRAB hospital-acquired pneumonia in elderly hospitalized patients of ICU. The thousand-day incidence rate of ventilator-associated pneumonia (VAP) among CRAB patients with hospital-acquired pneumonia was 42.49 ‰.
CONCLUSION The risk of CRAB hospital-acquired pneumonia in elderly ICU in inpatients is associated with the frequency of hospitalizations, the usage of antibiotics prior to CRAB detection(within 90 days), and albumin levels, on the basis of which early targeted infection prevention and control measures can be given to ICU elderly CRAB in patients to reduce the occurrence and cross transmission of hospital-acquired infections.
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