医院耐碳青霉烯类铜绿假单胞菌的流行及相关因素分析

发布时间：2018-09-18 15:31

【摘要】：目的:分析耐碳青霉烯类铜绿假单胞菌(CRPA)发生的流行趋势及相关因素,为CRPA的防治提供临床依据。方法:回顾性分析某院2012年1月-2014年12月946株铜绿假单胞菌对碳青霉烯类的耐药情况,2014年1月-12月281例铜绿假单胞菌阳性患者的临床资料,采用χ2检验、秩和检验、Logistic回归等分析CRPA的发生率及危险因素。结果:CRPA检出率由2012年的41.5%升至2014年的46.9%,与抗菌药物使用强度明显相关(r=0.738,P=0.006)。高龄[相对比值比(OR)=1.028,95%可信区间(95%CI)1.012~1.045,P=0.001]、入住ICU(OR=3.849,95%CI1.776~8.338,P=0.001)、机械通气(OR=3.313,95%CI 1.504~7.295,P=0.003)和经验性使用广谱抗菌药物(OR=2.352,95%CI 1.136~4.872,P=0.021)是CRPA检出的独立危险因素。在广谱抗菌药物中,使用碳青霉烯类(OR=13.326,95%CI 5.783~30.709,P=0.000)和β-内酰胺酶抑制剂复方制剂(OR=3.273,95%CI 1.403~7.633,P=0.006)与CRPA的检出有关。结论:医院CRPA检出率较高,应加强管理,以减少耐药株的播散和流行。
[Abstract]:Objective: to analyze the prevalence trend and related factors of carbapenem tolerant Pseudomonas aeruginosa (CRPA) in order to provide clinical basis for the prevention and treatment of CRPA. Methods: the drug resistance of 946 Pseudomonas aeruginosa strains to carbapenem from January 2012 to December 2014 was retrospectively analyzed. The clinical data of 281 patients with positive Pseudomonas aeruginosa from January to December 2014 were analyzed and 蠂 2 test was used. The incidence and risk factors of CRPA were analyzed by rank sum test and logistic regression. Results the positive rate of specific CRPA increased from 41.5% in 2012 to 46.9% in 2014, which was significantly correlated with the intensity of antimicrobial use (r 0.738P0. 006). Elderly patients [relative ratio of (OR) 1.028 95% confidence interval (95%CI) 1.012 1. 045% P0.001], admission to ICU (OR=3.849,95%CI1.776~8.338,P=0.001), mechanical ventilation (OR=3.313,95%CI 1. 504 / 7.295 P0. 003) and experiential use of broad-spectrum antibiotics (OR=2.352,95%CI 1. 136 + 4. 872P0.021) were independent risk factors for CRPA detection. In broad-spectrum antimicrobial agents, the use of carbapenems (OR=13.326,95%CI 5.783n 30.709 P0. 000) and 尾 -lactamases inhibitor compound (OR=3.273,95%CI 1.403C7.633P0.006) were related to the detection of CRPA. Conclusion: the detection rate of CRPA in hospital is high, so the management should be strengthened to reduce the spread and prevalence of drug resistant strains.
【作者单位】：秦皇岛市第一医院;
【基金】：河北省卫生厅基金项目(编号:20130288)
【分类号】：R446.5

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