目的探讨鲍氏不动杆菌下呼吸道医院感染的危险因素及其耐药状况。方法回顾性分析2004~2009年医院47例鲍氏不动杆菌下呼吸道医院感染及96例鲍氏不动杆菌下呼吸道定植患者的临床资料及耐药情况,对鲍氏不动杆菌下呼吸道医院感染的危险因素分别进行单因素及多因素Logistic回归分析,并就鲍氏不动杆菌的下呼吸道医院感染株与定植株的耐药状况进行对比。结果导致鲍氏不动杆菌医院下呼吸道感染的危险因素主要包括,患者APACHEⅡ评分>15分、罹患慢性阻塞性肺疾病、2周内使用三代头孢菌素及糖皮质激素4种因素;对临床常用9种抗菌药物耐药率,鲍氏不动杆菌下呼吸道医院感染株明显高于定植株;感染株中多药耐药株比例为100.0%,而定植株中多药耐药株为27.1%;感染株对头孢哌酮/舒巴坦及碳青酶烯类抗菌药物保持较高敏感性。结论病情严重、罹患COPD、近期使用第三代头孢菌素及糖皮质激素易出现鲍氏不动杆菌下呼吸道医院感染,且感染株耐药现象严重。 Objective To investigate the risk factors and drug resistance of Acinetobacter baumannii lower respiratory tract nosocomial infection. Methods The clinical data and drug resistance of 47 cases of Acinetobacter baumannii lower respiratory tract nosocomial infection and 96 cases of Acinetobacter baumannii lower respiratory tract colonization in hospitals from 2004 to 2009 were analyzed retrospectively. The infection rate of Acinetobacter baumannii lower respiratory tract nosocomial infection The risk factors were respectively univariate and multivariate Logistic regression analysis, and the Acinetobacter baumannii lower respiratory tract hospital infection and plant resistance were compared. As a result, the risk factors of lower respiratory tract infection in Acinetobacter baumannii hospital mainly included four factors: APACHEⅡscore> 15, chronic obstructive pulmonary disease, third-generation cephalosporins and glucocorticoid within two weeks; Nine antibacterial drug resistance rates and hospital infection strains of Acinetobacter baumannii lower respiratory tract were significantly higher than those of the colonized plants. The proportion of multidrug resistant strains in the infected strains was 100.0%, while the multidrug resistant strains in the colonized plants were 27.1%. Infected strains of cefoperazone / sulbactam and carbapenem-based antimicrobial agents to maintain a high sensitivity. Conclusions Serious illness and COPD, recent use of third-generation cephalosporins and glucocorticoid prone to lower respiratory tract infection of Acinetobacter spp., And the infection of drug-resistant strains.