论文部分内容阅读
[目的]探讨某院分离的医院感染铜绿假单胞菌对亚胺培南耐药的医源性危险因素。[方法]收集2005年1月1日～2007年12月31日住院病人的临床送检标本分离的101株非重复医院感染铜绿假单胞菌,通过回顾病历资料,以亚胺培南耐药铜绿假单胞菌为病例组,亚胺培南敏感铜绿假单胞菌为对照组,采用SPSS13.0版统计软件进行单因素χ2检验和相关性分析。调查内容包括患者住院时间、使用抗生素的种类、有无混合感染、是否使用亚胺培南、使用亚胺培南时间、是否使用哌拉西林或哌拉西林/他唑巴坦、三、四代头孢菌素、喹诺酮类、氨基糖苷类、大环内酯类、糖肽类、是否使用激素、是否接受侵入性操作共13个因素。[结果]混合感染、使用亚胺培南、使用哌拉西林或哌拉西林/他唑巴坦、使用三、四代头孢菌素、使用喹诺酮类、使用氨基糖苷类、使用糖肽类、侵入性操作、住院时间、使用抗生素的种类、使用亚胺培南时间(P﹤0.05)是铜绿假单胞菌对亚胺培南耐药的医源性危险因素。[结论]为减少铜绿假单胞菌对亚胺培南耐药,在限制使用亚胺培南同时,应尽可能根据药敏试验结果,合理使用抗菌药物;同时应严格消毒隔离措施,防止耐药菌株的定植和传播。
[Objective] To explore the iatrogenic resistance risk factors of hospital-acquired Pseudomonas aeruginosa isolated in a hospital. [Method] A total of 101 non-repetitive hospital-acquired Pseudomonas aeruginosa isolates were collected from clinical samples of inpatients from Jan. 1, 2005 to Dec. 31, 2007. By reviewing the medical records, Pseudomonas aeruginosa was the case group and imipenem-sensitive Pseudomonas aeruginosa was used as the control group. SPSS 13.0 software was used to test the single factor χ2 test and correlation analysis. The survey included length of hospital stay, type of antibiotic used, presence or absence of mixed infection, whether imipenem was used, duration of imipenem use, whether piperacillin or piperacillin / tazobactam was used, days three and four Cephalosporins, quinolones, aminoglycosides, macrolides, glycopeptides, whether or not to use hormones, whether to accept invasive operation of a total of 13 factors. [Results] Mixed infection with imipenem, use piperacillin or piperacillin / tazobactam, use of third- and fourth-generation cephalosporins, quinolones, use of aminoglycosides, use of glycopeptides, invasion Sexual operation, length of stay, types of antibiotics used, duration of imipenem use (P <0.05) were iatrogenic risk factors for resistance to imipenem in Pseudomonas aeruginosa. [Conclusion] In order to reduce the resistance of Pseudomonas aeruginosa to imipenem, antibiotics should be used reasonably according to the results of susceptibility test while restricting the use of imipenem. At the same time, the disinfection measures should be strictly sterilized to prevent the resistance Colonization and spread of drug strains.