多重耐药铜绿假单胞菌院内感染的临床耐药特征及危险因素分析

Clinical resistance characteristics and risk factors of multidrug resistant pseudomonas aeruginosa nosocomial infections

目的探讨多重耐药铜绿假单胞菌院内感染的临床耐药特征,并分析其危险因素,为预防多重耐药铜绿假单胞菌产生及抗菌药物合理使用提供依据。方法回顾性分析某三甲医院2018年10月—2020年4月收治的124例铜绿假单胞菌院内感染患者的临床资料,依据药敏结果将其分为多重耐药铜绿假单胞菌组和非多重耐药铜绿假单胞菌组,并采用logistic回归分析多重耐药铜绿假单胞菌院内感染的危险因素。结果多重耐药铜绿假单胞菌对不同抗生素呈现不同程度的耐药特征。多因素logistic回归分析结果显示,入住ICU (OR=2.341)、抗生素使用天数(OR=1.719)、抗生素使用种类(OR=2.064)、侵入性操作(OR=2.026)、合并脑血管疾病(OR=1.759)为多重耐药铜绿假单胞菌院内感染的危险因素(P<0.05)。结论在临床治疗中,不建议单独应用头孢唑林、厄他培南、头孢噻肟等治疗多重耐药菌铜绿假单胞菌感染。应采取针对性的应对措施以减少多重耐药铜绿假单胞菌的产生。

Objective To explore the clinical drug resistance characteristics of nosocomial infection of multidrug resistant pseudomonas aeruginosa,and analyze its risk factors,so as to provide basis for the prevention of multidrug resistant pseudomonas aeruginosa and rational use of antibiotics.Methods The clinical data of 124 patients with nosocomial infection of pseudomonas aeruginosa treated in a hospital from October,2018 to April,2020 were analyzed retrospectively.According to the results of drug sensitivity,they were divided into two groups:multidrug resistant pseudomonas aeruginosa group and non-multidrug resistant pseudomonas aeruginosa group.The risk factors of nosocomial infection of multi-drug resistant pseudomonas aeruginosa were analyzed by logistic regression.Results Multiple drug-resistant pseudomonas aeruginosa showed different degrees of resistance to different antibiotics.The results of multivariate logistic regression showed that admission to ICU(OR=2.341),days of antibiotic use(OR=1.719),type of antibiotic use(OR=2.064),invasive operation(OR=2.026) and cerebrovascular disease(OR=1.759) were independent risk factors for nosocomial infection of multidrug resistant pseudomonas aeruginosa(P<0.05).Conclusion In clinical treatment,cefazolin,ertapenem and cefotaxime,etc are not recommended to treat nosocomial patients with multidrug resistant pseudomonas aeruginosa infection.It is suggested to adopt targeted measures to reduce the incidence of multidrug-resistant pseudomonas aeruginosa.