52例重症监护病房铜绿假单胞菌感染的临床特点与耐药性分析

Clinical characteristics and drug resistance of 52 cases of Pseudomonas aeruginosa infection in intensive care unit

目的:分析重症监护病房(ICU)患者52例出现铜绿假单胞菌(PA)感染的临床特点与耐药性。方法:选取2018年8月-2020年10月发生PA感染的ICU患者52例,分析其临床特点与耐药情况。结果:ICU出现PA感染的患者多为老年人(51.92%)。标本主要为痰液标本(82.69%),诱发因素主要为合并基础疾病(57.69%),伴有黄痰(69.23%),伴发热体征(67.31%),伴发肺部啰音(55.77%),呼吸机治疗(48.08%),低蛋白血症(75.00%),双肺病变(96.15%),糖皮质激素治疗(42.31%)和手术(69.23%)。PA对于哌拉西林的耐药性达85.16%,对头孢噻肟的耐药性达88.64%,对复方新诺明的耐药性达89.00%。PA对阿米卡星、舒巴坦、多黏菌素B的敏感性超70%。结论:PA菌株多源自呼吸道,且诱发因素多样,对常用抗菌药有明显耐药性,需要加强用药监控,首选阿米卡星等敏感性药物,临床对感染PA的患者进行积极治疗,以避免PA在ICU内传播。

Ojective:To analyze the clinical characteristics and drug resistance of 52 patients with peudomonas aeruginosa infection(PA)in the intensive care unit(ICU).Methods:From August 2018 to October 2020,52 ICU patients with PA infection were selected,we analyzed the clinical characteristics and drug resistance.Results:The patients with PA infection in ICU were mostly elderly(51.92%).The predisposing factors mainly included sputum specimens(82.69%),combined with underlying diseases(57.69%),accompanied by yellow sputum(69.23%),and signs of fever(67.31%),pulmonary rales(55.77%),ventilator therapy(48.08%),hypoproteinemia(75.00%),double lung disease(96.15%),glucocorticoid therapy(42.31%)and surgery(69.23%).The resistance of PA to piperacillin reached 85.16%,the resistance to cefotaxime reached 88.64%,and the resistance to compound trimethoprim reached 89.00%.PA is more than 70%sensitive to amikacin,sulbactam,and polymyxin B.Conclusion:PA strains mostly originate from the respiratory tract and have various predisposing factors.They have obvious resistance to commonly used antibacterial drugs.It is necessary to strengthen drug monitoring.Sensitive drugs such as amikacin are the first choice to avoid the spread of PA in the ICU.