目的:分析广泛耐药鲍曼不动杆菌(XDRAB)的流行菌株及医院获得性肺炎的特点.方法:收集广州市第一人民医院临床分离的非重复XDRAB菌株31株,进行分子流行病学分型,回顾性分析XDRAB肺炎的特点.结果:31株XDRAB被分为8个ST型,其中ST195最常见,占45.2%(14/31).APACHE Ⅱ评分(P=0.034)、慢性阻塞性肺疾病(COPD)(P=0.012)和心脏疾病(P=0.016)是XDRAB肺炎的独立危险因素.XDRAB肺炎死亡率高达42.8%,但与非XDRAB肺炎相比,住院死亡率差异无统计学意义(P=0.582).结论:鲍曼不动杆菌ST195广泛存在,XDRAB肺炎与COPD、心脏疾病及APACHE Ⅱ评分相关,但不增加死亡风险.%Objective:To investigate the clinical characteristics of extensive drug-resistant Acinetobacter baumannii (XDRAB) epidemic strains and hospital-acquired pneumonia (HAP).Methods:Thirty-one non-repeated XDRAB strains,which were clinically isolated from Guangzhou First Municipal People's Hospital,were included and analyzed for molecular epidemiologic typing.The characteristics of XDRAB pneumonia were retrospectively analyzed.Results:Thirty-one strains of XDRAB were divided into 8 ST types,of which ST195 was the most common,accounting for 45.2% (14/31).APACHE Ⅱscore (P=0.034),chronic obstructive pulmonary disease(COPD)(P=0.012) and heart disease (P=0.016) were independent risk factors for XDRAB pneumonia.The mortality rate of XDRAB pneumonia reached to 42.8%,but there was no statistically significant difference in hospital mortality (P=0.582) compared with non-XDRAB pneumonia.Conclusion:Acinetobacter baumannii ST195 exists widely.XDRAB pneumonia is associated with COPD,heart disease and APACHE Ⅱscore,but does not increase the risk of death.
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