耐亚胺培南铜绿假单胞菌医院感染危险因素分析

Risk factors of nosocomial infections caused by imipenem-resistant pseudomonas aeruginosa

目的分析耐亚胺培南铜绿假单胞菌(IRPA)产生的危险因素。方法收集医院2004年1月-2010年10月IRPA引起的56例医院感染患者的病历资料(IRPA组),对照组为62例医院感染敏感铜绿假单胞菌患者(敏感组),均按常规方法对进行分离培养和鉴定,采用纸片扩散(K-B)法进行药敏试验;IRPA组与敏感组之间比较计数资料采用t检验、χ2检验及多因素logistic回归进行分析。结果 t检验、χ2检验结果提示,年龄、混合感染、机械通气、患有慢性阻塞性肺疾病(COPD)、用过亚胺培南/美罗培南为IRPA医院感染相关因素;多因素logistic回归分析结果表明,机械通气,OR值为10.13及用过亚胺培南/美罗培南,OR值为36.68,为IRPA医院感染独立危险因素。结论机械通气以及亚胺培南/美罗培南的使用是IRPA医院感染的危险因素。

OBJECTIVE To investigate the risk factors for imipenem resistant Pseudomonas aeruginosa（IRPA） infections.METHODS A total of 56 cases of IRPA nosocomial infections were analyzed from Jan,2004 to Oct,2010 in Xiaogan central hospital.62 cases of antibiotic-sensitive P.aeruginosa infection were enrolled as control.Chi-square test and student t test and logistic regression analysis were used for statistics.RESULTS The factors associated with the development of IRPA nosocomial infection were age,co-infection,mechanical ventilation,COPD,fluoroquinolone and imipenem/meropenem use.Multivariate logistic regression analysis identified two independent factors： mechanical ventilation and previous imipenem/meropenem use.CONCLUSION Mechanical ventilation and previous imipenem/meropenem are the independent risk factors for IRPA infection.