实验与检验医学
實驗與檢驗醫學
실험여검험의학
EXPERIMENTAL AND LABORATORY MEDICINE
2014年
3期
260-263
,共4页
王平珍%刘秋龙%周庆华%郝会青
王平珍%劉鞦龍%週慶華%郝會青
왕평진%류추룡%주경화%학회청
多重耐药铜绿假单胞菌%危险因素%耐药性
多重耐藥銅綠假單胞菌%危險因素%耐藥性
다중내약동록가단포균%위험인소%내약성
Multiple drug-resistance Pseudomonas aeruginosa%Risk factors%Drug-resistance
目的：探讨多重耐药铜绿假单胞菌(MDRP)医院感染的危险因素与耐药性分析，为临床合理用药提供科学依据。方法对临床标本分离的586株铜绿假单胞菌采用黑马迪尔的96NE板进行药敏试验，分析其耐药性，并对其感染的危险因素采用单因素分析(χ2检验与t检验)和多因素分析logistic回归方法进行分析。结果586株铜绿假单胞菌中多重耐药菌有84株(占14.3%)。单危险因素及多危险因素分析得出既往入住ICU治疗、机械介入、使用碳青霉烯类抗菌药物是多重耐药铜绿假单胞菌感染的独立危险因素。12种常用抗菌药物中，多重耐药铜绿假单胞菌对头孢哌酮/舒巴坦的耐药率最低，为27.4%，对庆大霉素和环丙沙星的耐药率最高，分别为90.5%、92.9%。多重耐药铜绿假单胞菌对头孢他啶的耐药率由2008年的61.5%下降到2012年的39.1%，对亚胺培南、美罗培南和替卡西林/克拉维酸的耐药率由2008年的38.5%、38.5%、46.2%上升到2012年的52.2%、52.2%、78.3%。结论多重耐药铜绿假单胞菌的耐药性已十分严重，临床应重视监测药敏结果，根据药敏结果合理使用抗菌药物，同时还应重视多重耐药铜绿假单胞菌感染的各种危险因素，以减少和控制细菌耐药的发生。
目的：探討多重耐藥銅綠假單胞菌(MDRP)醫院感染的危險因素與耐藥性分析，為臨床閤理用藥提供科學依據。方法對臨床標本分離的586株銅綠假單胞菌採用黑馬迪爾的96NE闆進行藥敏試驗，分析其耐藥性，併對其感染的危險因素採用單因素分析(χ2檢驗與t檢驗)和多因素分析logistic迴歸方法進行分析。結果586株銅綠假單胞菌中多重耐藥菌有84株(佔14.3%)。單危險因素及多危險因素分析得齣既往入住ICU治療、機械介入、使用碳青黴烯類抗菌藥物是多重耐藥銅綠假單胞菌感染的獨立危險因素。12種常用抗菌藥物中，多重耐藥銅綠假單胞菌對頭孢哌酮/舒巴坦的耐藥率最低，為27.4%，對慶大黴素和環丙沙星的耐藥率最高，分彆為90.5%、92.9%。多重耐藥銅綠假單胞菌對頭孢他啶的耐藥率由2008年的61.5%下降到2012年的39.1%，對亞胺培南、美囉培南和替卡西林/剋拉維痠的耐藥率由2008年的38.5%、38.5%、46.2%上升到2012年的52.2%、52.2%、78.3%。結論多重耐藥銅綠假單胞菌的耐藥性已十分嚴重，臨床應重視鑑測藥敏結果，根據藥敏結果閤理使用抗菌藥物，同時還應重視多重耐藥銅綠假單胞菌感染的各種危險因素，以減少和控製細菌耐藥的髮生。
목적：탐토다중내약동록가단포균(MDRP)의원감염적위험인소여내약성분석，위림상합리용약제공과학의거。방법대림상표본분리적586주동록가단포균채용흑마적이적96NE판진행약민시험，분석기내약성，병대기감염적위험인소채용단인소분석(χ2검험여t검험)화다인소분석logistic회귀방법진행분석。결과586주동록가단포균중다중내약균유84주(점14.3%)。단위험인소급다위험인소분석득출기왕입주ICU치료、궤계개입、사용탄청매희류항균약물시다중내약동록가단포균감염적독립위험인소。12충상용항균약물중，다중내약동록가단포균대두포고동/서파탄적내약솔최저，위27.4%，대경대매소화배병사성적내약솔최고，분별위90.5%、92.9%。다중내약동록가단포균대두포타정적내약솔유2008년적61.5%하강도2012년적39.1%，대아알배남、미라배남화체잡서림/극랍유산적내약솔유2008년적38.5%、38.5%、46.2%상승도2012년적52.2%、52.2%、78.3%。결론다중내약동록가단포균적내약성이십분엄중，림상응중시감측약민결과，근거약민결과합리사용항균약물，동시환응중시다중내약동록가단포균감염적각충위험인소，이감소화공제세균내약적발생。
Objective To investigate the risk factors and drug-resistance of Pseudomonas aeruginosa in nosocomial infections and provide the scientific evidence for the clinical use of the antibiotics. Methods A total of 586 strains of Pseudomonas aerugi-nosa isolated from clinical specimens were conducted drug sensitivity test by using 96NE plate from Black Madill's company, and the drug resistance of these strains were analyzed. The statistical analyses of the single factor analysis (χ2 and t test) and multivari-ate logistic regression methods were used to analyze the risk factors of multidrug drug-resistant Pseudomonas aeruginosa infection. Results There were 84 strains of multidrug resistant Pseudomonas aeruginosa in the 586 strains of Pseudomonas aeruginosa, which accounted for 14.3%. Previous treatment in the ICU, mechanical intervention procedures, and the use of carbapenem antibiotics were the independent risk factors of infection of multiple drug resistant Pseudomonas aeruginosa. Among the 12 kinds of antibi-otics, the drug-resistance rate of multiple drug-resistance Pseudomonas aeruginosa to cefoperazone/sulbactam was the lowest (27.4%). And the drug-resistance rate to gentamicin and ciprofloxacin were 90.5%and 92.9%, respectively, which were the high-est. The drug resistance rate of multiple drug-resistance Pseudomonas aeruginosa to ceftazidime fell from 61.5%in 2008 to 39.1%in 2012. And the drug-resistance rates to imipenem, meropenem and ticarcillin/clavulanic increased from 38.5%, 38.5% and 46.2%in 2008 to 52.2%, 52.2%and 78.3%in 2012, respectively. Conclusions The drug-resistance rates of multiple drug-resis-tance Pseudomonas aeruginosa are very serious. In order to reduce and control the occurrence of multiple drug-resistance bacteria, clinician should use antibiotics rationally according to the results of drug susceptibility test and pay attention to the various risk factors of multiple drug-resistant Pseudomonas aeruginosa infection.
