李宜昌Yi-Chang Li許秀繡HSIU-HSIU HSU國際健康產業經營管理碩士在職專班2026-03-232021/7/1920212021/6/25https://handle.ncl.edu.tw/11296/r838v2https://scholars.csmu.edu.tw/handle/123456789/6360本研究目的建立加護病房抗藥性鮑氏不動桿菌(CRAB)之醫療照護相關感染預測模式。方法:以某醫學中心2015至2020年入住加護病房病人為研究對象(病例組:對照組=1:4配對)，排除主動篩檢細菌培養報告陽性病人。結果:研究對象共235人，抗藥性鮑氏不動桿菌醫療照護相關感染47人，主要感染部位是血流感染(44.7%)、泌尿道感染(40.4%)、手術部位感染(6.4%)、肺炎感染(4.3%)、其他部位感染(4.3%)。以Univariate logistic regression分析結果具有統計學上顯著差異(p＜0.1)，包括年齡、慢性阻塞性肺病、肝硬化、尿毒症、股靜脈導管、全靜脈營養輸液、使用vancomycin、Imipenem、Ceftazidime及Ciprofloxacin抗生素;Multivariate logistic regression分析結果具有統計學上顯著差異(p＜0.1)，包括年齡、慢性阻塞性肺病、肝硬化、尿毒症、股靜脈導管、全靜脈營養輸液、使用Imipenem抗生素。本研究結論:抗藥性鮑氏不動桿菌(CRAB)醫療照護相關感染與股靜脈導管及使用Imipenem抗生素有顯著關聯性。因此醫護人員落實中心靜脈導管組合式照護、包括植管部位避免選擇股靜脈及適當抗生素管理，為預防抗藥性鮑氏不動桿菌醫療照護相關感染的重要策略。The purpose of this study was to Establish a model to predict carbapenem-resistant Acinetobacter baumannii (CRAB) healthcare-associated infections in intensive care unit.Method:Patients admitted to the intensive care unit of a medical center from 2015 to 2020 (case:control=1:4)were included. Patients with positive bacterial culture reports on active surveillance were excluded.Results: There were 235 subjects in the study, 47 of them were infected with Carbapenem-resistant Acinetobacter baumannii. The main sites of infection were bloodstream infection (44.7%), urinary tract infection (40.4%), surgical site infection (6.4%), and pneumonia (4.3%), infection in other parts (4.3%).Logistic regression univariate analysis results showed that age, chronic obstructive pulmonary disease, liver cirrhosis,uremia,femoral vein catheters,TPN ,and use of vancomycin ,Imipenem,Ceftazidime, Ciprofloxacin antibiotics have significant differences(p<0.1).Multivariate analysis showed that age, chronic obstructive pulmonary disease, liver cirrhosis,uremia, femoral vein catheter, TPN and use of Imipenem antibiotics have significant differences(p<0.1). Conclusion of this study: Carbapenem-resistant Acinetobacter baumannii (CRAB) healthcare -associated infections are significantly associated with femoral venous catheters and use of Imipenem.Therefore, the implementation of central venous catheter bundle care, including the avoidance of femoral vein catheterization and appropriate antibiotic use ,are important strategies for prevention of Carbapenem-resistant Acinetobacter baumannii healthcare-associated infections.抗藥性鮑氏不動桿菌醫療照護相關感染危險因子Carbapenem-resistant Acinetobacter baumanniiHealthcare-associated infectionsrisk factorsthesis