铜绿假单胞菌产生耐药性的相关因素分析

Analysis of Related Factors of Drug Resistance Caused by Pseudomonas Aeruginosa in Hospital

目的探讨铜绿假单胞菌对常用抗菌药物产生耐药性的影响因素。方法以2004年1月1日至2005年12月31日医院细菌室培养分离出的129株铜绿假单胞菌为研究对象,对患者病历作回顾性调查,用SPSS10.0进行统计学分析。结果铜绿假单胞菌耐头孢他啶(CAZ)、环丙沙星(CIP)的共同影响因素为年龄≥60岁;而住院时间≥3周、抗菌药物使用时间≥4周是铜绿假单胞菌耐CAZ的另两个影响因素;铜绿假单胞菌耐CIP的另外影响因素有鼻饲胃管时间≥7d、中草药的使用;而铜绿假单胞菌耐亚胺培南西司他丁(IPM)的其他影响因素还有气管切开(机械通气)、留置尿管时间≥7d。结论铜绿假单胞菌对CAZ,CIP,IPM的耐药影响因素不尽相同。高龄、住院时间长、抗菌药物使用时间长、侵袭性操作时间长是该院铜绿假单胞菌耐药的主要影响因素;因该院为中医院,对症中草药的大量使用是降低细菌耐药率的又一影响因素。

Objective To analyze the related factors of the resistance to common antibiotics caused by Pseudomonas Aeruginosa in Hospital. Methods 129 strains of resistant Pseudomonas Aeruginosa isolated in our hospital between 1 January 2004 and 31 December 2005 and the medical records of the patients were retrospectively investigated with statistical analysis by using SPSS10. 0. Results The following factors were significant（P〈0.05） associated with Pseudomonas aeruginosa resistant to CAZ： age≥60 years, hospital stay≥3weeks, antibiotics usage≥4weeks; to CIP： age≥60 years, nasal feeding usage≥7 d, while using Chinese herb medicine was a protective factor; to IPM： bronchotomy, time of indwelling urethral catheters≥7 d. Conclusion The related factors of resistance to CAZ, CIP and IPM caused by Pseudomonas aeruginosa are different. Old age, long stay in hospital, long antibiotics usage and long invasive operation are mainly factors, while using Chinese herb medicine is a protective factor for reducing the drug resistant rate.