耐亚胺培南铜绿假单胞菌感染的危险因素及其耐药性分析

Analysis of Risk Factors and Drug Resistance of Imipenem-Resistant Pseudomonas Aeruginosa Infection

目的:分析耐亚胺培南铜绿假单胞菌感染的危险因素及其耐药性。方法:选取2019年1月-2021年1月海安市人民医院收治的耐亚胺培南铜绿假单胞菌感染患者120例作为试验组,选取同期100例对亚胺培南敏感的铜绿假单胞菌感染者作为对照组。首先,分离病原菌,分析患者对抗菌药物的耐药情况;其次,进行单因素分析,并采用多因素logistic回归分析耐亚胺培南铜绿假单胞菌感染的危险因素。结果:120株耐亚胺培南铜绿假单胞菌菌株对多黏菌素B较为敏感,对其他类型抗菌药物具有不同程度的耐药性;单因素及多因素Logistic回归分析结果显示,住院时间≥4周、入住ICU、机械通气、之前使用过亚胺培南、联用抗菌药物>3 d均为耐亚胺培南铜绿假单胞菌感染的独立危险因素(OR=2.298、1.758、2.201、2.517、2.088,P<0.05)。结论:亚胺培南铜绿假单胞菌菌株对多黏菌素B较为敏感,且住院时间≥4周、入住ICU、机械通气、之前使用过亚胺培南、联用抗菌药物>3 d均为耐亚胺培南铜绿假单胞菌感染的独立危险因素,临床中应尽早给予预防措施,防止耐亚胺培南铜绿假单胞菌感染的情况发生。

Objective:To analyze the risk factors and drug resistance of imipenem-resistant Pseudomonas aeruginosa infection.Methods:A total of 120 patients with imipenem-resistant Pseudomonas aeruginosa infection admitted to Haian People's Hospital from January 2019 to January 2021 were selected as test group,and 100 patients with imipenem-sensitive Pseudomonas aeruginosa infection were selected as control group during the same time period.Firstly,the pathogenic bacteria were isolated,and the patient's resistance to antibiotics was analyzed;secondly,univariate analysis was performed,and multivariate Logistic regression analysis was used to analyze the risk factors of imipenem-resistant Pseudomonas aeruginosa infection.Results:120 imipenem-resistant Pseudomonas aeruginosa strains were sensitive to polymyxin B and had different degrees of resistance to other types of antibiotics;Univariate and multivariate Logistic regression analysis showed that hospitalization time≥4 weeks,admission to ICU,mechanical ventilation,previous use of imipenem,and combined use of antibiotics for>3 days were independent risk factors for imipenem-resistant Pseudomonas aeruginosa infection(OR=2.298,1.758,2.201,2.517,2.088,P<0.05).Conclusion:Imipenem Pseudomonas aeruginosa strains are more sensitive to polymyxin B,the hospitalization time≥4 weeks,ICU admission,mechanical ventilation,previous use of imipenem,and combined use of antibiotics for>3 days are independent risk factors for imipenem-resistant Pseudomonas aeruginosa infection.It is suggested to take clinical protective measures early so as to prevent the occurrence of imipenem-resistant Pseudomonas aeruginosa infection.