摘要
目的分析碳青霉烯类抗生素耐药铜绿假单胞菌感染的临床特征。方法对2017年1~12月昆山市第一人民医院55例碳青霉烯类耐药铜绿假单胞菌(CRPA)和85例碳青霉烯类敏感铜绿假单胞菌(CSPA)感染病例进行回顾性队列分析。结果昆山市第一人民医院院CRPA感染患者在重症监护病房(ICU)(32.72%)、神经外科(30.91%)和神经内科(12.73%)的占比显著高于CSPA在相应科室中的分布(分别为14.12%,8.24%和8.24%)。CRPA感染患者中脑外伤41.82%和脑血管意外30.91%,显著高于CSPA感染患者的7.06%和18.82%。CRPA组患者发热(74.55%)、休克(27.27%)和低蛋白血症(70.91%)占比显著高于CSPA组患者(56.47%、15.29%和47.06%)。多种细菌感染、机械通气、PPI为CRPA感染的独立危险因素。结论我院CRPA患者的病情多较严重,引起呼吸衰竭甚至多脏器衰竭的可能性很大,预后欠佳,前期合理使用抗生素、加强脑外伤和脑血管疾病患者呼吸道并发症的预防、做好院内感染的管理,可能有助于改善CRPA的现状。
Objective To analysed the clinical characteristics of the Carbapenems-resistant Pseudomonas aeruginosa(CRPA)infection.Methods 55 patients with CRPA infection and 85 patients with CSPA(the Carbapenems-sensitive Pseudomonas aeruginosa)infection were recruited in the First people′s hospital of Kunshan city,from January to December 2017,and a retrospective cohort analysis was carried out.Results 32.72%patients with CRPA infection were found in department of ICU,30.91%in department of neurosurgery and 12.735 in department of neurology,significantly higher than the corresponding distribution of patients with CSPA infection,respectively 14.12%,8.24%and 8.24%.In accord to this finding,most patients infected with CRPA suffered from existed brain trauma(41.82%)or stroke(30.91%).More fever(74.55%),shock(27.27%)and hypoproteinemia(70.91%)were found in CRPA group than in CSPA group(respectively 56.47%,15.29%and 47.06%).It′s indicated thatmultiple bacterial infection,mechanical ventilation and proton pump inhibitor were independent risk factors for CRPA infection.Conclusions Most of patients with CRPA infection in our hospital were seriously ill and likely to cause respiratory failure even multiple organ failure,leading to poor clinical prognosis.It′s in urgent need to promote rational use of antibiotics in the early stage of the disease,strengthen the prevention of respiratory complications for patients withbrain trauma and cerebrovascular disease and improve the management of nosocomial infection for control of CRPA in hospital.
作者
姜明子
周兴菊
Jiang Mingzi;Zhou Xingju(Department of Respiratory and Critical Care Medicine,the First People′s Hospital of Kunshan City,Kunshan 215300,China)
出处
《国际呼吸杂志》
2019年第20期1543-1547,共5页
International Journal of Respiration
