重症医学科患者铜绿假单胞菌感染的危险因素及耐药性研究

Risk factors and drug resistance of pseudomonas aeruginosa infection in critically ill patients

目的分析重症医学科(ICU)患者铜绿假单胞菌(PA)感染的危险因素及耐药性。方法选定洛阳市东方人民医院2021年8月至2023年8月ICU住院的268例患者,根据是否感染PA将其分组,86例感染PA患者设为PA组,182例未感染PA患者设为非PA组,logistic回归分析PA感染的危险因素,PA感染患者分泌物、血液、痰液、尿液送检标本,进行耐药性分析。结果Logistic回归分析发现气管切开[OR值(95%CI)=2.942(1.752,10.288),P=0.004]、抗菌药物使用时间[OR值(95%CI)=4.167(1.841,13.674),P=0.015]、APACHEⅡ评分≥16分[OR值(95%CI)=3.504(1.285,9.064),P=0.010]是PA感染的危险因素。PA对左氧氟沙星的耐药性最强,耐药率为95.4%,其次是环丙沙星,耐药率为90.7%。结论气管切开、抗菌药物使用时间、APACHEⅡ评分≥16分是ICU患者PA感染的危险因素,PA对左氧氟沙星、环丙沙星的耐药性最强,应当引起临床重视。

Objective To analyze the risk factors and drug resistance of Pseudomonas aeruginosa(PA)in-fection in intensive care unit(ICU)patients.Methods Two hundred and sixty eight patients admitted to the ICU of Dongfang People′s Hospital in Luoyang from August 2021 to August 2023 were selected.They were divided into two groups based on whether they were infected with PA;86 patients with PA were assigned to the PA group,and 182 patients without PA were assigned to the non-PA group.Logistic regression analysis was conducted to identify the risk factors for PA infection,and samples of secretions,blood,sputum,and urine from PA infected patients were analyzed for drug resistance.Results Logistic regression analysis:Tracheostomy[OR(95%CI)=2.942(1.752,10.288),P=0.004],duration of antibiotic use[OR(95%CI)=4.167(1.841,13.674),P=0.015]and APACHEⅡscore≥16[OR(95%CI)=3.504(1.285,9.064),P=0.010]were risk factors for PA infection.PA has the strongest resistance to levofloxacin with a resistance rate of 95.4%,followed by ciprofloxacin with a resistance rate of 90.7%.Conclusion Tracheostomy,duration of antibiotic use,and APACHEⅡscore≥16 are risk factors for PA infection in ICU patients.PA has the strongest resistance to levofloxacin and ciprofloxacin,and should be given clinical attention.