摘要
目的了解西安地区耐亚胺培南铜绿假单胞菌（i mipenem-resistant pseudomonas aeruginosa,IRPA）的感染现状及危险因素分析。方法收集2003年12月至2004年6月间西安地区6所三级甲等医院细菌室从临床标本分离到的非重复性铜绿假单胞菌（pseudomonas aeruginosa,PA）,采用标准纸片扩散法（Kirby Bauer,KB法）检测PA对13种药物的敏感性,并回顾性分析引起IRPA感染的危险因素。结果共分离PA258株,IRPA为113株,总分离率达43.80%;神经科和ICU分离率较高,分别为64.56%和53.33%;标本中痰的IRPA分离率最高为50.23%;除亚胺培南外,IRPA对替卡西林/克拉维酸耐药率最高（80.53%）,对环丙沙星耐药率最低（23.89%）;单因素分析发现患者住院时间≥4周、曾入住ICU、机械通气、气管插管（或切开）以及2周内接受过碳青酶烯类抗生素治疗与IRPA感染有关,但多因素Logistic回归仅确定了2项独立危险因素：入住ICU病房（RR=6.994）和2周内接受碳青酶烯类治疗（RR=5.553）。结论西安地区IRPA分离率较高,神经科和ICU是主要来源病区,IRPA主要表现为多重耐药。入住ICU和2周内接受过碳青酶烯类抗生素治疗是IRPA感染的独立危险因素。
Objective To investigate the situation of prevalence for imipenem-resistant Pseudomonas aeruginosa （IRPA） in Xi＇an and the risk factors for IRPA infections. Methods The susceptivity to 13 antibiotics of nonduplicated pseudomonas aeruginosa （PA） isolated from 6 hospitals＇ clinical microbe laboratories collected from Dec. 2003 to Jun. 2004 were detected by Kirby Bauer （KB） method. Retrospective study was performed to investigate risk factors that were relevant to the infections due to IRPA. Chi-square test and Logistic regression analysis were used for statistics. Results （1）Among 258 strains of non repeated PA isolated from 6 hospitals, 113 of them were IRPA, the total isolated rate was 43. 80%. IRPA mainly isolated from department of neurology and ICU, the rates were 64.56% and 53. 33%, respectively. The isolated rate of sputum was the highest （50.23%）. The resistance rate of IRPA to ticarcillinl/clavuledc acid （TIM） was the highest （80.53%）, and that to ciprofloxacin was the lowest （23.89%）. （2） According to univariate analysis,the factors associated with the IRPA nosocomial infection were ： length of patient stay≥4 weeks,ever stay in ICU, mechanical ventilation, tracheal intubation or incision of trachea, and previous carbapenems use. Multivariate logistic regression analysis identified two independent factors： previous carbapenems use（RR=5. 553） and ever stay in ICU（RR=6. 994）. Conclusions In Xi＇an,the isolated rate of IRPA was a higher level. IRPA was mainly isolated from department of neurology and ICU. IRPA shows the multiple drug resistance. Independent risk factors of IRPA infections are admission in ICU and used carbapenems.
出处
《国际呼吸杂志》
2007年第18期1365-1368,共4页
International Journal of Respiration
基金
基金项目：陕西省科学技术研究发展计划项目（编号：2004K17-G3）
关键词
耐亚胺培南铜绿假单胞菌
耐药性
危险因素
Imipenem-resistant pseudomonas aeruginosa
Drug-resistance, Risk factors
