耐碳青霉烯类铜绿假单胞菌感染的危险因素调查研究

Investigation on Risk Factors of Carbapenem-resistant Pseudomonas Aeruginosa Infection

目的:探讨耐碳青霉烯类铜绿假单胞菌(carbapene-resistant pseudomonas aeruginosa,CRPA)感染的危险因素和预后影响因素。方法:采取病例对照研究的方法,回顾性分析2017年1—10月南昌大学第一附属医院发生CRPA感染的45例患者的电子病例资料,设为研究组,纳入同期入院后合并碳青霉烯类敏感铜绿假单胞菌感染患者的33为对照组。对两组患者基线资料、机械通气时间、ICU治疗时间、免疫抑制剂应用时间及经验性使用碳青霉烯类抗菌药物情况等,运用单因素和多因素的条件logistic回归分析危险因素与预后影响因素。结果:是否进行手术、是否进行过侵入性操作、是否使用氨基糖苷类抗菌药物与血型是感染的独立危险因素。结论:CRPA感染形势严峻,预后较差,合理使用抗菌药物,减少不必要侵入诊疗等是减少其感染,提高疗效的措施。

Objective:To investigate the risk factors and prognostic factors of pseudomonas aeruginosa infection resistant to carbapenems.Method:Case-control studies were used,the electronic case data of 45 patients with CRPA infection in the first affiliated hospital of nanchang university from January to October 2017 were retrospectively analyzed,and the study group was set up,33 patients with carbapenems sensitive pseudomonas aeruginosa infection after admission at the same time were included as the control group.Baseline data,mechanical ventilation time,ICU treatment time,application time of immunosuppressive agents,and empirical use of carbapenems were analyzed by using logistic regression of single and multiple factors to analyze risk factors and prognostic factors.Result:Whether an operation has been performed,whether an invasive procedure has been performed,and whether aminoglycoside drugs and blood groups are independent risk factors for infection.Conclusion:The situation of CRPA infection is serious,the prognosis is poor,the rational use of antimicrobial agents,the reduction of unnecessary invasion diagnosis and treatment is to reduce its infection and improve the therapeutic effect.