铜绿假单胞菌对头孢他啶耐药率及其影响因素

Drug Resistance of Pseudomonas aeruginosa to Ceftazidime and Its Risk Factors

目的分析某院铜绿假单胞菌肺部感染患者对头孢他啶的耐药率和耐药影响因素,为临床防治铜绿假单胞菌感染提供科学依据。方法采用VITEK GNI+自动化系统对某院2005年1-12月临床痰标本分离出的109株铜绿假单胞菌进行种属鉴定和药敏检测;回顾性调查感染患者的基础疾病、合并证及住院期间危险因素暴露情况;用SPSS13.0对相关数据进行Logistic回归分析。结果肺部感染铜绿假单胞菌对头孢他啶的耐药率为38.53%,尤其入住ICU和神经外科病室的铜绿假单胞菌肺部感染患者,对头孢他啶耐药率达到78.57%和54.84%;肺部感染铜绿假单胞菌患者感染前住院>2 d、入住ICU、神经外科病室、使用呼吸机等是其耐头孢他啶的危险因素。结论防治耐头孢他啶铜绿假单胞菌感染,应重点监测ICU和神经外科病室,患者感染前住院天数、入住不同病室、使用呼吸机与耐头孢他啶铜绿假单胞菌有关。

OBJECTIVE To explore the drug resistance rate and risk factor of Pseudomonas aeruginosa against ceftazidime in a certain hospital, and provide scientific basis for preventing the P. aeruginosa infections. METHODS A total of 109 P. aeruginosa strains, which were isolated from sputum cultures in patients in a certain hospital in 2005, were identified with VITEK GNI＋ automation system. The possible risk factors and underlying diseases were investigated by reviewing patients＇ medical records. Multiple Logistic regression models were used for statistical analyses by SPSS software（13.0）. RESULTS The resistant ratios against ceftazidime was 38.5 %. P. aeruginosa resistant ratios in ICU and the neurosurgery ward were 78.57% and 54.84%, respectively, and higher than others. Treatment days before infection in hospital （over two days）, staying at the ICU or neurosurgery ward, using breathing machine, were associated with the sensitivity to ceftazidime for P. aeruginosa. CONCLUSIONS In order to prevent and reduce the drug resistant ratios for P. aeruginosa, we should pay more attention to the patients admitted in ICU and neurosurgery wards. Risk factors, such as treatment days in hospital, living in different wards and using breathing machine, were associated with the resistant ratios for P. aeruginosa against ceftazidime.