Résumé
Objective To assess the risk factors of carbapenem -resistant Acinetobacter baumannii (CRAB) infection.Methods Clinical data of patients with positive bacterial culture in Tianjin Medical University General Hospital during January 2011 and December 2015 were retrospectively analyzed, including 68 patients with carbapenem resistant Acinetobacter baumannii (CRAB) bacteremia, 68 patients with carbapenem sensitive Acinetobacter baumannii ( CSAB) bacteremia, and 68 patients with positive culture of other bacteria (control group).The risk factors of Acinetobacter baumannii infection were analyzed by univatiate and multivariate Logistic regression analyses .Results Univariate analysis showed that bacteremia /sepsis,use of carbapenems,β-lactamase inhibitor compound,tigecycline,combined antibiotics, glucocorticoids,surgery within one month, mechanical ventilation, central venous catheters ( CVCs ), arteriopuncture,indwelling catheter≥3 days and indwelling gastric tube were risk factors of CRAB infection (CRAB vs.control: χ2 =4.96,15.56,7.64,9.22,5.89,6.80,17.00,11.83,18.22,8.24,25.24 and 7.70, P <0.05 or P <0.01, respectively); while use of third-generation cephalosporin,CVCs,length of hospital stay were risk factors of CSAB infection (CSAB vs.control: χ2 =11.93 and 6.94,U =1555, P <0.05).Multivariate logistic analysis showed that bacteremia /sepsis (OR =4.01, 95%CI:1.13 ~14.20), use of carbapenems (OR =4.17, 95%CI :1.79 ~9.73), CVCs (OR =2.93, 95% CI: 1.22 ~7.08), indwelling catheter≥3 days (OR =6.08,95%CI:2.39 ~15.46) were independent risk factors of CRAB infection; use of third-generation cephalosporin (OR =3.98, 95% CI :1.88 ~8.43 ),CVCs(OR =3.40, 95% CI:1.48 ~7.81) were independent risk factors of CSAB infection .Conclusions Long-term use of carbapenems and invasive procedures are associated with CRAB infection , strict control of invasive procedures and rational use of antibiotics may reduce CRAB infection .
Résumé
Objective To explore the risk factors of patients with re -treatment multidrug resistant pulmonary tuberculosis (MDR -TB)and to provide suggestions for intervention.Methods A case -case control study was carried out between patients with or without re -treatment MDR -TB,with a questionnaire interview and multivariate logistic regression analysis to explore the risk factors of re -treatment MDR -TB.Results A total of 172 patients were enrolled in this study including 99 re -treatment MDR -TB patients and 73 re -treatment non -MDR -TB patients(P >0.05).There was no significant difference between case group and control group in gender,age,residence and marital status.The sick time,the anti -tuberculosis treatment time,the number of anti -tuberculosis treatments,the rate of adverse reactions,history of taking isoniazid or rifampicin and the number of treatment interruption were higher in cases than those in control group(P <0.05),while the months of first -treatment were lower than those in control group(P <0.05).The number of anti -tuberculosis treatments(≥3),adverse reactions during treatment,the months of first -treatment were significant risk factors by the multivariable regression model,with the adjusted ORs and 95%CIs of 5.07 (1.89,13.64),4.27 (2.04, 8.94)and 2.35(1.06,5.22),respectively.Conclusion The number of anti -tuberculosis treatments,adverse reactions during treatment,the months of first -treatment were risk factors of patients with re -treatment MDR -TB.