难治性耐药铜绿假单胞菌血流感染的危险因素分析

Analysis of risk factors for bloodstream infection of refractory drug-resistant Pseudomonas aeruginosa

目的探讨难治性耐药铜绿假单胞菌(DTR-PA)血流感染患者的临床特点和危险因素。方法回顾性分析2017年1月至2022年12月中山大学附属第一医院发生铜绿假单胞菌血流感染的患者病历资料,采用多因素Logistic回归分析探究DTR-PA血流感染的独立危险因素,采用Cox比例风险回归模型探讨铜绿假单胞菌血流感染死亡相关的危险因素。结果共纳入114例铜绿假单胞菌血流感染患者,平均年龄(51.05±17.55)岁,28 d死亡率为14.0%(16/114),DTR-PA共有24株(21.1%,24/114)。年龄、入住ICU、糖尿病、低白蛋白血症、感染性休克与DTR-PA血流感染有关(P<0.05)。多因素Logistic回归分析显示,感染性休克是患者发生DTR-PA血流感染的独立危险因素(P<0.05)。入住ICU是铜绿假单胞菌及DTR-PA血流感染患者死亡的独立危险因素(P<0.05)。结论DTR-PA血流感染的危险因素有多种,感染性休克和入住ICU分别是DTR-PA血流感染和死亡的独立危险因素,临床应重视对该类菌的监测。

Objective To explore the bloodstream infection of refractory drug-resistant Pseudomonas aeruginosa(DTR-PA)patients with clinical characteristics and risk factors.Methods Clinical data of patients with Pseudomonas aeruginosa bloodstream infection in the First Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2022 were retrospectively analyzed.Multivariate Logistic regression analysis was used to explore the independent risk factors for DTR-PA bloodstream infection.Cox proportional hazards regression was used to explore the risk factors related to the death of Pseudomonas aeruginosa bloodstream infection.Results A total of 114 patients with Pseudomonas aeruginosa bloodstream infection were enrolled,with an average age of(51.05±17.55)years.The 28 d mortality was 14.0%(16/114),and 24 patients(21.1%,24/114)had DTR-PA.Age,ICU admission,diabetes,hypoproteinemia and septic shock were associated with DTR-PA bloodstream infection(P<0.05).Multivariate Logistic regression analysis showed that septic shock was an independent risk factor for DTR-PA bloodstream infection(P<0.05).ICU admission was an independent risk factor for the death of patients with DTR-PA and Pseudomonas aeruginosa bloodstream infection(P<0.05).Conclusion There are many risk factors for DTR-PA bloodstream infection.Septic shock and ICU admission are independent risk factors for DTR-PA bloodstream infection and death,respectively.