CAJ | 학술논문

目的：探讨院内感染铜绿假单胞菌的耐药情况及危险因素。方法收集2010年1月至2013年12月院内感染铜绿假单胞菌266株，回顾性分析患者的临床资料，分析耐药情况以及感染耐药菌株的危险因素。结果266株中，敏感菌株73株，1~2类耐药菌株49株，多重耐药菌株114株，泛耐药菌株30株。药物敏感性试验结果显示，2010年至2013年院内感染铜绿假单胞菌对β－内酰胺酶类抗菌药物中替卡西林( TIC，52.26%）、派拉西林( PIP，48.50%）耐药率均较高。多因素分析结果显示，1~2类耐药的危险因素是吸痰，多重耐药的危险因素是使用碳青霉烯类抗菌药物和入住重症监护室(ICU)，泛耐药的危险因素是机械通气和使用碳青霉烯类抗菌药物（ P <0.05或<0.01）。结论铜绿假单胞菌近年来的院内感染率逐渐升高，而耐药率也逐渐升高，尤其是多重耐药甚至泛耐药。导致耐药的高危因素包括吸痰、机械通气、使用碳青霉烯类抗生素、入住 ICU 等。
목적：탐토원내감염동록가단포균적내약정황급위험인소。방법수집2010년1월지2013년12월원내감염동록가단포균266주，회고성분석환자적림상자료，분석내약정황이급감염내약균주적위험인소。결과266주중，민감균주73주，1~2류내약균주49주，다중내약균주114주，범내약균주30주。약물민감성시험결과현시，2010년지2013년원내감염동록가단포균대β－내선알매류항균약물중체잡서림( TIC，52.26%）、파랍서림( PIP，48.50%）내약솔균교고。다인소분석결과현시，1~2류내약적위험인소시흡담，다중내약적위험인소시사용탄청매희류항균약물화입주중증감호실(ICU)，범내약적위험인소시궤계통기화사용탄청매희류항균약물（ P <0.05혹<0.01）。결론동록가단포균근년래적원내감염솔축점승고，이내약솔야축점승고，우기시다중내약심지범내약。도치내약적고위인소포괄흡담、궤계통기、사용탄청매희류항생소、입주 ICU 등。
Objective To discuss Pseudomonas aeruginosa drug resistance and risk factors of nosocomial infection. Methods Collected 266 Pseudomonas aeruginosa nosocomial infections in January 2010 to December 2013, clinical data were analyzed, and pseudomonas aeruginosa drug resistance and risk factors were analyzed. Results Of 266 strains, sensitive strains were 73, 1 - 2 class resistant strains were 49, MDRPA strains were 114, PDRPA strains were 30. Susceptibility results showed that 2010 - 2013 nosocomial infections of pseu-domonas aeruginosa drug resistances to β - lactam antimicrobial agents of TIC (52. 26% ), PIP (48. 50% ) were higher. Multivariate analysis showed that suctioning was risk factor of 1 - 2 class resistant strains, usage of carbapenems, ICU admission were risk factors of MDRPA, and mechanical ventilation and usage of carbapenems were risk factors of PDRPA( P < 0. 05, P < 0. 01) . Conclusion Pseu-domonas aeruginosa nosocomial infection rates increases in recent years, and drug resistances increases too, especially MDRPA and MDR-PA. The risk factors leading to drug resistance include suctioning, mechanical ventilation, usage of carbapenems, ICU admission and so on.