舟山地区耐亚胺培南铜绿假单胞菌耐药特征及感染危险因素分析  

Analysis of Drug Resistance Characteristics of Imipenem-resistant Pseudomonas aeruginosa and Infection Risk Factors in Zhoushan Area

作　　者：孙春雷 干朝晖 姚宝锋 

机构地区：[1]舟山市普陀区人民医院重症医学科,浙江舟山316100

出　　处：《中国药房》2016年第8期1061-1063,共3页China Pharmacy

摘　　要：目的:为临床控制耐亚胺培南铜绿假单胞菌感染提供参考依据。方法:选择2013年2月-2014年2月舟山地区3家三级医院感染耐亚胺培南铜绿假单胞菌的患者114例,从其临床标本中分离出铜绿假单胞菌共计114株,分析菌株耐药特征及产碳青霉烯酶基因多样性;感染危险因素分析以同期住院的对亚胺培南敏感的铜绿假单胞菌感染的101例患者作为对照组,通过单因素及Logistic多因素回归分析,探讨耐亚胺培南铜绿假单胞菌感染的危险因素。结果:114株铜绿假单胞菌均对多黏菌素B敏感,对其他9种抗菌药物均有不同程度耐药;其产碳青霉烯酶基因携带情况以IMP、VIM基因为主。长时间住院、机械通气、之前使用过亚胺培南及早期联合应用抗菌药物是耐亚胺培南铜绿假单胞菌感染危险因素。结论:舟山地区耐亚胺培南铜绿假单胞菌耐药现象较为严重,避免长时间住院、早期联合应用抗菌药物等可降低耐亚胺培南铜绿假单胞菌感染率。OBJECTIVE：To provide reference for imipenem-resistant Pseudomonas aeruginosa infection control. METHODS：114 patients infected with imipenem-resistant P. aeruginosa were selected from 3 tertiary hospitals in Zhoushan during Feb. 2013 to Feb. 2014. 114 strains of P. aeruginosa were isolated from clinical specimens,and drug resistance characteristics and carbapenemase-producing gene diversity were analyzed. 101 inpatients with imipenem-resistant P. aeruginosa infection were included in control group;univariate and multivariate Logistic regression analysis were adopted to explore the risk factors of imipenem-resistant P.aeruginosa infection. RESULTS：114 strains were sensitive to polymyxin B,and had different levels of resistance to other 9 kinds of antibiotics. Carbapenemase-producing gene were mainly IMP and VIM type gene. Long-term hospitalization,mechanical ventilation,used imipenem and early combined use of antibiotics were risk factors of imipenem-resistant P. aeruginosa infection. CONCLUSIONS：In Zhoushan area,imipenem-resistant P. aeruginosa shows serious drug resistance. To avoid long-term hospitalization and early combined use of antibiotics can reduce imipenem-resistant P. aeruginosa infection.

关 键 词：亚胺培南 铜绿假单胞菌 耐药性 碳青霉烯酶 基因多态性 危险因素 

分 类 号：R978.1[医药卫生—药品]