支气管扩张症患者感染多重耐药铜绿假单胞菌的影响因素分析

Risk factors for infection of multi-drug resistant Pseudomonas aeruginosa in patients with bron-chiectasis

目的探讨支气管扩张症患者感染多重耐药铜绿假单胞菌(MDRP)的影响因素,为临床合理应用抗菌药物、减少多重耐药菌的产生提供科学依据。方法回顾性分析因支气管扩张症伴感染导致住院且痰培养分离出铜绿假单胞菌(PA)的患者病历资料,依据药物敏感试验结果分为MDRP组与非MDRP组,采用t检验、χ2检验和Wilcoxon秩和检验对临床资料进行初筛,再行Logistic逐步回归分析,探讨MDRP感染的影响因素。结果共纳入98株PA,其中MDRP组34株,非MDRP组64株,经统计分析,近1年住院次数(OR=2.419,95%CI 1.559~3.752,P<0.001)、ICU/呼吸重症监护病房(RICU)入住史(OR=4.486,95%CI 1.290~15.602,P=0.018)、咯血(OR=4.702,95%CI 1.110~19.918,P=0.036)是MDRP感染的影响因素。结论近1年频繁住院、ICU/RICU入住史、咯血是MDRP感染的重要危险因素。

Objective To explore the risk factors for the infection of multi-drug resistant Pseudomonas aeruginosa(MDRP)in patients with bronchiectasis,and to provide scientific basis for the rational application of antimicrobial agents and the reduction of multi-drug resistant bacteria(MDROs).Method Retrospective analysis was performed on the data of patients who hospitalized with bronchiectasis associated with infection and isolated Pseudomonas aeruginosa(PA)from sputum culture.These cases were divided into MDRP group and non-MDRP group according to drug sensitivity results.Student’s-test,Chisquare test or Wilcoxon rank sum test was used to screen the clinical data,and then Logistic stepwise regression analysis was performed to explore the independent risk factors for MDRP infection.Results A total of 98 PA strains were collected,including 34 in the MDRP group and 64 in the non-MDRP group.Statistical analysis showed that hospitalization frequency in the recent one year(OR=2.419,95%CI 1.559-3.752,P<0.001),ICU/RICU hospitalization history(OR=4.486,95%CI 1.290-15.602,P=0.018),hemoptysis(OR=4.702,95%CI 1.110-19.918,P=0.036)were independent risk factors for MDRP infection.Conclusion Frequent hospitalization in the recent one year,ICU/RICU hospitalization history,hemoptysis are important risk factors for MDRP infection,and identification of these characteristics is beneficial to the prevention and treatment of MDRP.