摘要
目的研究慢性阻塞性肺疾病(COPD)合并下呼吸道感染患者大肠埃希菌耐药情况及相关耐药基因分布特点。方法选择本院2017年12月-2018年12月确诊为COPD合并大肠埃希菌感染的患者120例作为研究对象,收集病原体标本并进行药敏实验,分析耐药组(n=60)和非耐药组(n=60)的临床资料,采用RT-PCR法检测大肠埃希菌相关耐药基因,Logistic回归分析大肠埃希菌耐药感染的危险因素。结果耐药组发热时间、最高体温、呼吸道症状时间、白细胞总数、住院时间、住院费用、双肺病变发生、胸腔积液、合并心血管疾病发生率均明显高于非耐药组(P<0.05);耐药组病原体耐药相关基因检出率均明显高于非耐药组(P<0.05);多因素分析结果证实,双肺病变、CTX-M9、CTX-M8、CTX-M2是耐药菌感染的独立危险因素(P<0.05)。结论COPD合并大肠埃希菌耐药感染患者耐药基因表达率较高,与患者病情密切相关。
Objective To investigate the drug resistance of Escherichia coli and the distribution of drug resistance genes in patients with chronic obstructive pulmonary disease(COPD)complicated with lower respiratory tract infection.Methods A total of 120 patients with COPD complicated with Escherichia coli infection diagnosed in our hospital from December 2017 to December 2018 were selected as research objects.Pathogen samples were collected and drug sensitivity tests were carried out.The clinical data of drug-resistant group(n=60)and non-drug-resistant group(n=60)were analyzed.The related drug-resistant genes of Escherichia coli were detected by RT-PCR.The risk factors of drug-resistant infection of Escherichia coli were analyzed by regression analysis.Results The fever time,maximum body temperature,respiratory symptoms time,total white blood cell count,hospitalization time,hospitalization expenses,occurrence of bilateral lung diseases,pleural effusion and cardiovascular diseases in drug-resistant group were significantly higher than those in non-drug-resistant group(P<0.05);the detection rate of drug-resistant pathogens related genes was significantly higher in drug-resistant group than in non-drug-resistant group(P<0.05).Multivariate analysis confirmed that bilateral lung lesions,CTX-M9,CTX-M8 and CTX-M2 were independent risk factors for drug-resistant bacterial infection(P<0.05).Conclusion The expression rate of drug resistance genes in COPD patients with drug-resistant infection of Escherichia coli is high,which is closely related to the patient's condition.
作者
蒲爱华
马红映
高春荣
PU Ai-hua;MA Hong-ying;GAO Chun-rong(Department of Respiratory Medicine,Ningbo Sixth Hospital,Ningbo,Zhejiang 315040,China)
出处
《中国卫生检验杂志》
CAS
2020年第15期1825-1827,1830,共4页
Chinese Journal of Health Laboratory Technology
关键词
下呼吸道感染
大肠埃希菌
耐药基因
慢性阻塞性肺疾病
Lower respiratory tract infection
Escherichia coli
Drug resistance genes
Chronic obstructive pulmonary disease
