目的 分析2013—2014年邯鄲市中心醫(yī)院銅綠假單胞菌的分布、耐藥性及危險(xiǎn)因素,為防治銅綠假單胞菌感染提供依據(jù)。方法 對(duì)2013年1月—2014年12月邯鄲市中心醫(yī)院分離出的957株銅綠假單胞菌的分布、耐藥性及危險(xiǎn)因素進(jìn)行回顧性分析。結(jié)果 銅綠假單胞菌感染科室以重癥醫(yī)學(xué)科、神經(jīng)外科、呼吸內(nèi)科居多;標(biāo)本來源以痰標(biāo)本、導(dǎo)管尖、尿液為主;藥敏試驗(yàn)結(jié)果顯示,銅綠假單菌對(duì)頭孢噻肟、氨曲南、阿莫西林克拉維酸鉀耐藥率較高,分別為93.6%、46.1%、32.5%;危險(xiǎn)因素分析顯示,住院時(shí)間、抗生素使用天數(shù)、吸痰、呼吸機(jī)、氣管插管、深靜脈插管、鼻飼插管、導(dǎo)尿管、混合感染真菌、合并感染病原體≥3種等因素與多重耐藥銅綠假單胞菌感染相關(guān)(P <0.05)。結(jié)論 銅綠假單胞菌感染率較高的科室應(yīng)注重合理選擇抗菌藥物種類及用藥療程,侵襲性操作時(shí)應(yīng)嚴(yán)格無菌性操作,以降低銅綠假單胞菌感染。

Objective To study the distribution, drug resistance and risk factors of Pseudomonas aeruginosa in Handan Central Hospital, and to provide basis for clinical prevention of P. aeruginosa infection. Methods The distribution, drug resistance and risk factors of P. aeruginosa (957 strains) in Handan Central Hospital from 2013 January to 2014 December were analyzed retrospectively. Results The main departments of P. aeruginosa infection were ICU, department of neurosurgery, respiratory medicine. The specimens were mainly obtained from sputum, catheter tip, and urine samples. Susceptibility test results showed that the resistance rates of P. aeruginosa against cefotaxime, aztreonam, amoxicillin, and clavulanate potassium were relatively high, which were 93.6%, 46.1%, and 32.5%. Analysis of risk factors showed that multi-drug resistant P. aeruginosa infection was closely related to hospitalization time, the days of antibiotic use, suction ventilator, endotracheal intubation, deep venous catheter, nasogastric intubation, catheter, mixed fungal infection, and mixed infection pathogen ≥ 3 (P < 0.05). Conclusion The departments with high P. aeruginosa infection rates should focus on the type of rational choice of antibiotics and medication treatment, and invasive procedures should be strictly aseptic operation, to reduce P. aeruginosa infection.