某肿瘤医院耐碳青霉烯类铜绿假单胞菌下呼吸道感染患者临床特征及危险因素  

Clinical characteristics and risk factors of lower respiratory tract infection caused by carbapenem-resistant Pseudomonas aeruginosa in a tumor hospital

作　　者：杨兴肖[1] 李锦锦 王媛[1] 何艳凛[1] 刘志广[1] 孔洁羽 王翯童 邢亚威[1] YANG Xing-xiao;LI Jin-jin;WANG Yuan;HE Yan-lin;LIU Zhi-guang;KONG Jie-yu;WANG He-tong;XING Ya-wei(The Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050011,China)

机构地区：[1]河北医科大学第四医院感染管理科,河北石家庄050011

出　　处：《中华医院感染学杂志》2022年第16期2425-2428,共4页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81903118);河北省自然基金资助项目(H2020206292)。

摘　　要：目的研究耐碳青霉烯类铜绿假单胞菌下呼吸道感染特征及相关危险因素。方法采用回顾性病例对照方法,分别收集2017年1月-2020年6月98例碳青霉烯类耐药的铜绿假单胞菌(CRPA)下呼吸道感染患者和101例碳青霉烯类敏感的铜绿假单胞菌(CSPA)下呼吸道感染患者的临床资料,并分析下呼吸道CRPA感染患者的临床特征及危险因素。结果铜绿假单胞菌感染患者的标本来源主要是痰液,CRPA组、CSPA组分别为90.82%、91.09%。科室分布以重症监护病房(ICU)、胸外科为主,CRPA分别占44.90%、15.31%,CSPA分别占17.82%、28.71%。多因素分析结果显示住ICU时间(≥7 d)、近2周内使用过碳青霉烯类抗菌药物是导致下呼吸道CRPA感染患者的独立危险因素(P<0.05)。结论下呼吸道CRPA感染形势严峻,减少不必要的机械通气、胃管插管等侵入性诊疗操作,合理使用抗菌药物、缩短患者住ICU时间等可有效降低下呼吸道CRPA感染率。OBJECTIVE To study the characteristics and related risk factors of lower respiratory tract infection caused by carbapenem-resistant Pseudomonas aeruginosa(CRPA).METHODS Clinical data of 98 patients with lower respiratory tract infection resistant to carbapenems P aeruginosa from Jan 2017 to Jun 2020 were collected by retrospective case-control method.Data of another 101 patients infected with carbapenem-sensitive P aeruginosa(CSPA)were also collected.The clinical characteristics and risk factors of CRPA infection were analyzed.RESULTS Sputum was the main source of specimen,with the composition ratios of 90.82%and 91.09%in the CRPA and CSPA group,respectively.ICU and thoracic surgery were the main departments;the composition ratios of CRPA in them were 44.90%and 15.31%,and composition ratios of CSPA were 17.82%and 28.71%,respectively.Multivariate Logistic analysis showed that length of ICU stay≥7 d,and having used carbapenem-resistant antibiotics within 2 weeks were independent risk factors for CRPA in patients with lower respiratory tract infection(P<0.05).CONCLUSION The situation of Lower respiratory tract infection caused by CRPA is serious.Reducing unnecessary mechanical ventilation and gastric tube intubation,using antibiotics rationally,and shortening ICU length of stay may effectively decrease the infection rate of lower respiratory tract caused by CRPA.

关 键 词：碳青霉烯 铜绿假单胞菌 下呼吸道感染 危险因素 肿瘤医院 临床特征 

分 类 号：R446.5[医药卫生—诊断学]