医院铜绿假单胞菌的临床特征及危险因素分析

Analysis of clinical infection distribution and risk factors of Pseudomonas aeruginosa in hospital

目的分析我院铜绿假单胞菌临床特征及感染危险因素,为控制医院感染和合理应用抗菌药物提供参考。方法分析2018—2019年我院分离的铜绿假单胞菌的临床分布及耐药性;采用单因素和Logistic回归探讨耐碳青霉烯铜绿假单胞菌(carbapenem-resistant Pseudomonas aeruginosa, CRPA)感染的危险因素。结果 CRPA占铜假绿单胞菌的21.34%(150/703)。铜绿假单胞菌和CRPA主要分离自痰标本(61.02%和60.67%),分布于ICU病区(47.82%和52.00%)。铜绿假单胞菌对多种抗菌药物耐药率较高,对多黏菌素B、阿米卡星敏感率达100%和98.44%。回归分析显示,基础疾病、侵入性操作、同时感染其他病原菌、ICU的OR值分别为14.470、12.677、9.216和6.381,P值均<0.05。结论铜绿假单胞菌主要分离自痰标本,分布于ICU病区,耐药情况较重;基础疾病、侵入性操作、同时感染其他病原菌及ICU是CRPA感染的危险因素。

Objective To investigate the clinical features and risk factors of Pseudomonas aeruginosa in our hospital in order to provide references for the control of hospital infections and the application of antibacterial drugs.Methods The clinical distribution and drug resistance of Pseudomonas aeruginosa isolated from our hospital in 2018—2019 were analyzed. Single factor and Logistic regression were used to analyze risk factors of carbapenemresistant Pseudomonas aeruginosa(CRPA). Results CRPA accounted for 21.34% of Pseudomonas aeruginosa(150/703). Pseudomonas aeruginosa and CRPA were mainly isolated from sputum specimens(61.02%, 60.67%)and distributed in ICU wards(47.82%, 52.00%). Pseudomonas aeruginosa had a high resistance rate to various antibacterial drugs and the sensitivity rates to polymyxin B and amikacin were up to 100% and 98.44%. Multivariate regression analysis showed that the OR values of basic disease, invasive treatment, co-infection with other pathogens,and ICU were 14.470, 12.677, 9.216, and 6.381, respectively, with P values all <0.05. Conclusion Pseudomonas aeruginosa was mainly isolated from sputum specimens and distributed in ICU wards. The drug resistance was serious.Basic diseases, invasive treatment, co-infection with other pathogens and ICU were major risk factors for CRPA infection.