多药耐药铜绿假单胞菌感染危险因素的荟萃分析

发布时间：2018-05-27 07:23

  本文选题：铜绿假单胞菌 + 感染　； 参考：《中华医院感染学杂志》2016年05期

【摘要】：目的通过荟萃分析探讨国内多药耐药铜绿假单胞菌(MDRPA)感染的危险因素,为其感染预防与控制提供依据和借鉴。方法通过计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库(VIP)以及PubMed等数据库,检索关于国内MDRPA感染危险因素的病例对照研究,检索时间均为建库至2015年6月,按纳入、排除标准由两人独立进行文献筛选、资料提取和质量评价后,采用RevMan5.0软件进行荟萃分析。结果纳入研究共6个,MDRPA感染患者345例,铜绿假单胞菌敏感菌株感染患者851例,荟萃分析结果显示,入住ICU/RCU、患有支气管扩张/慢性阻塞性肺疾病、混合感染、留置胃管、气管切开/插管、机械通气及感染前使用三、四代头孢菌素、喹诺酮类及碳青霉烯类抗菌药物、联用两类或两种抗菌药物、联用3类或3种抗菌药物等因素,MDRPA感染患者中比例明显高于PAE敏感患者;MDRPA感染患者感染前仅使用1类或1种抗菌药物的比例明显低于PAE敏感患者;MDRPA耐药性分析发现,耐药率最高的是庆大霉素和环丙沙星。结论 MDRPA感染与多个因素相关,临床医师应注意相关危险因素,合理使用抗菌药物,避免患者发生MDRPA感染。
[Abstract]:Objective to explore the risk factors of multidrug resistant Pseudomonas aeruginosa (MDRPA) infection in China by meta-analysis, and to provide reference for the prevention and control of MDRPA infection. Methods the database of Chinese biomedical literature (CBM), CNKIX, Wanfang database, Weip database and PubMed were searched by computer, and case-control studies on the risk factors of MDRPA infection in China were searched. The retrieval time is from the establishment of the database to June 2015. According to the inclusion and exclusion criteria, the documents are screened independently by two people. After the data is extracted and the quality is evaluated, the meta-analysis is carried out by using RevMan5.0 software. Results A total of 345 patients with MDRPA infection and 851 patients with Pseudomonas aeruginosa susceptible strains were included in the study. The results of meta-analysis showed that ICU / RCUpatients had bronchiectasis / chronic obstructive pulmonary disease, mixed infection, and gastric tube indwelling. Tracheotomy / intubation, mechanical ventilation and use of third or fourth generation cephalosporins, quinolones and carbapenes before infection, combined with two or two kinds of antimicrobial agents, The proportion of MDRPA-infected patients with MDRPA was significantly higher than that of MDRPA-sensitive patients with PAE before infection. The proportion of MDRPA-positive patients who only used class 1 or 1 antibiotics before infection was significantly lower than that of PAE sensitive patients. The highest drug resistance rates were gentamicin and ciprofloxacin. Conclusion MDRPA infection is related to many factors. Clinicians should pay attention to the related risk factors and use antibiotics rationally to avoid MDRPA infection.
【作者单位】： 上海市南翔医院感染管理科;上海市南翔医院医学检验科;复旦大学附属中山医院感染管理科;
【基金】：中华医院感染基金资助项目(ZHYY2013-022) 上海市嘉定区科学技术委员会基金资助项目(2014-KW-15)
【分类号】：R446.5
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本文编号：1941033