目的:分析老年患者耐碳青霉烯类鲍曼不动杆菌(CR-AB)感染的耐药性及预后的影响因素，确定急性生理学与慢性健康状况评分Ⅱ(APACHE II评分)对CR-AB老年感染者死亡的预测作用。方法:抽取株洲市中心医院2018年1月至2019年12月收治的老年CR-AB感染患者为研究对象，监测其CR-AB感染情况。依据感染后30 d内预后将患者分为死亡组(57例)和存活组(139例)。分析CR-AB感染老年患者的耐药性，统计分析老年CR-AB感染患者预后的危险因素。结果:2018年至2019年株洲市中心医院共196例年龄≥65岁患者发生CR-AB感染，感染部位以呼吸道最为常见，CR-AB对β-内酰胺类、氨基糖苷类耐药率最高，耐药率均>90.0%，其次为复方新诺明耐(65.1%)、替加环素(44.8%)，未产生多粘菌素耐药。Logistic多因素分析结果显示，年龄、入院后曾使用碳青霉烯类抗生素、机械通气时间≥7 d、高APACHEⅡ评分是影响CR-AB老年感染者预后的独立危险因素(n P<0.05)。APACHEⅡ评分预测CR-AB感染老年患者死亡的受试者工作特征曲线下面积为0.754(95%n CI：0.686～0.822，n P90.0%), followed by compound sulfamethoxazole (65.1%) and teicycline (44.8%), and no polymyxin resistance occurred. Logistic multivariate analysis showed that age, previous use of carbapenem antibiotics after admission, duration of mechanical ventilation ≥7 d, and high APACHE Ⅱ score were independent risk factors of prognosis in elderly patients with CR-AB infection( n P<0.05). The area under the receiver operating characteristic curve of APACHE Ⅱ score for predicting death in elderly patients with CR-AB infection was 0.754 (95%n CI: 0.686 - 0.822; n P<0.001), the cut-off points for diagnosis was 26.5, and the sensitivity and specificity were 64.9% and 70.5%, respectively.n Conclusions:The drug resistance of elderly patients with CR-AB infection is serious, and poor prognosis may occur in patients with the use of carbapenem antibiotics before infection and after admission, mechanical ventilation time ≥7 d, and high APACHE Ⅱ score. APACHE Ⅱ score has predictive value for the prognosis of elderly patients with CR-AB infection.