论文部分内容阅读
目的探讨耐亚胺培南铜绿假单胞菌(IRPA)导致医院感染的危险因素。方法选取2002年1月至2003年12月收治的67例IRPA医院感染病例、150例亚胺培南敏感铜绿假单胞菌(ISPA)医院感染者为病例组,同时选取同一病区,接受相似治疗措施的非铜绿假单胞菌感染的住院患者为对照组,其中敏感对照组159例,耐药对照组200例。分别对两组患者的危险因素进行病例对照研究,采用非条件logistic回归分析法进行分析。结果多因素非条件logistic回归分析表明,IRPA医院感染的发生与住院时间长短(OR=1.03,95%CI:1.01~1.04)、亚胺培南(OR=4.65,95%CI:1.35~11.52)、哌拉西林/他唑巴坦(OR=3.37,95%CI:1.85~9.43)及喹诺酮类抗菌药物(OR=1.85,95%CI:1.25~5.34)的使用有关;而ISPA医院感染与三代头孢(OR=2.54,95%CI:1.26~5.23)及氨基糖苷类抗生素(OR=1.86,95%CI:1.42~3.26)的使用、住院时间长短(OR=1.05,95%CI:1.03~1.05)有关。结论为减少IRPA医院感染的发生,在限制使用亚胺培南的同时,应尽可能根据药物敏感试验的结果,合理使用其他抗菌药物。
Objective To investigate the risk factors of nosocomial infections caused by imipenem-resistant Pseudomonas aeruginosa (IRPA). Methods Sixty-seven patients with IRPA were selected from January 2002 to December 2003 and 150 patients with imipenem-sensitive Pseudomonas aeruginosa (ISPA) were selected as the case group. At the same time, Treatment of non-Pseudomonas aeruginosa infections inpatients as a control group, of which 159 cases of sensitive control group, resistant control group of 200 cases. Case-control study was conducted on the risk factors of two groups of patients, respectively, using non-conditional logistic regression analysis. Results Multivariate non-conditional logistic regression analysis showed that the incidence of IRPA nosocomial infections was associated with the length of hospital stay (OR = 1.03, 95% CI: 1.01-1.04), imipenem (OR = 4.65, 95% CI: , Piperacillin / tazobactam (OR = 3.37, 95% CI: 1.85-9.43) and quinolone antibiotics (OR = 1.85,95% CI: 1.25-5.34) (OR = 1.04, 95% CI: 1.26-5.23) and aminoglycoside antibiotics (OR = 1.86,95% CI: 1.42-3.26) )related. Conclusions In order to reduce the incidence of IRPA nosocomial infections, while restricting the use of imipenem, other antibacterial drugs should be rationally used according to the results of drug susceptibility testing.