目的 分析2013—2014年邯郸市中心医院铜绿假单胞菌的分布、耐药性及危险因素,为防治铜绿假单胞菌感染提供依据。方法 对2013年1月—2014年12月邯郸市中心医院分离出的957株铜绿假单胞菌的分布、耐药性及危险因素进行回顾性分析。结果 铜绿假单胞菌感染科室以重症医学科、神经外科、呼吸内科居多;标本来源以痰标本、导管尖、尿液为主;药敏试验结果显示,铜绿假单菌对头孢噻肟、氨曲南、阿莫西林克拉维酸钾耐药率较高,分别为93.6%、46.1%、32.5%;危险因素分析显示,住院时间、抗生素使用天数、吸痰、呼吸机、气管插管、深静脉插管、鼻饲插管、导尿管、混合感染真菌、合并感染病原体≥3种等因素与多重耐药铜绿假单胞菌感染相关(P <0.05)。结论 铜绿假单胞菌感染率较高的科室应注重合理选择抗菌药物种类及用药疗程,侵袭性操作时应严格无菌性操作,以降低铜绿假单胞菌感染。

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.