评估多重耐药铜绿假单胞菌的共耐药率和患者预后研究  

Evaluation of Co-Resistance Rate and Patient Prognosis of Multi-Drug Resistant Pseudomonas Aeruginosa

作　　者：李玉巧 张子书 LI Yuqiao;ZHANG Zishu(Department of Respiratory and Critical Care Medicine,Xiangshui County People's Hospital,Xiangshui,Jiangsu 224600,China)

机构地区：[1]江苏省响水县人民医院呼吸与危重症医学科,江苏响水224600

出　　处：《转化医学杂志》2024年第11期2026-2029,共4页Translational Medicine Journal

基　　金：江苏省卫生健康委科研项目(H2020135)。

摘　　要：目的分析感染多重耐药(MDR)铜绿假单胞菌的共耐药率及对患者预后的影响。方法收集180例2021年1月至2023年12月在江苏省响水县人民医院因MDR铜绿假单胞菌感染住院的患者临床资料,回顾性分析MDR铜绿假单胞菌共耐药率及患者预后。结果常见共耐药模式分层非碳青霉烯类(CARB)、广谱头孢菌素(ESC)和哌拉西林-他唑巴坦(PT)共耐药性与CARB、ESC和PT相比,感染MDR铜绿假单胞菌患者的住院死亡率具有明显差异(P<0.0001,OR=5.14),出院后1年内再感染住院无统计学差异(P>0.05,OR=0.91)。MDR铜绿假单胞菌指数分离株对常用抗生素的单个耐药性、CARB和ESC加上PT耐药或氟喹诺酮类(FQ)耐药联合耐药率较高,CARB/ESC/PT和CARB/ESC/FQ共耐药模式中加入头孢洛扎-他唑巴坦(CT)与头孢他啶-阿维巴坦(CA),观察到最低的共耐药率。结论MDR铜绿假单胞菌共耐药率较高,CARB、ESC和PT共耐药模式对患者预后正相关,联合治疗相对单药治疗具有一定优势。Objective To analyze the co-resistance rate of multi-drug resistant(MDR)Pseudomonas aeruginosa infection and its impact on patient prognosis.Methods The clinical data of 180 patients hospitalized due to MDR Pseudomonas aeruginosa infection in Xiangshui People's Hospital of Jiangsu Province from January 2021 to December 2023 were collected.The co-resistance rate of multi-drug resistant Pseudomonas aeruginosa and patient prognosis were retrospectively analyzed.Results Stratified by common co-resistance patterns,there was a significant difference in the in-hospital mortality rate of patients infected with MDR Pseudomonas aeruginosa strains between the co-resistance of non-carbapenems(CARB),extended-spectrum cephalosporins(ESC)and piperacillin-tazobactam(PT)and CARB,ESC and PT(P<0.0001,OR=5.14),but there was no significant difference in readmission due to reinfection within one year after discharge(P>0.05,OR=0.91).The index isolates of MDR Pseudomonas aeruginosa had a high individual resistance rate to commonly used antibiotics,and a high combined resistance rate of resistance to CARB and ESC plus resistance to PT or fluoroquinolones(FQ).When ceftolozane-tazobactam(CT)and ceftazidime-avibactam(CA)were added to the co-resistance patterns of CARB/ESC/PT and CARB/ESC/FQ,the lowest co-resistance rate was observed.Conclusion The co-resistance rate of multi-drug resistant Pseudomonas aeruginosa is relatively high.The co-resistance pattern of CARB,ESC and PT is positively correlated with patient prognosis.Combined therapy has certain advantages over single-drug therapy.

关 键 词：多重耐药铜绿假单胞菌 共耐药率 患者预后 联合治疗 

分 类 号：R974[医药卫生—药品]