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目的探讨分析多重耐药铜绿假单胞菌院内感染的危险因素及药物敏感。方法 2014年10月-2015年9月期间,东丽区东丽医院共分离了112株铜绿假单胞菌,采用标准制片扩散法检测其对八种药物的敏感性,同时将多重耐药铜绿假单胞菌筛选出来,采用单因素分析法和多因素分析法,分析多重耐药铜绿假单胞菌感染的危险因素。结果 112株铜绿假单胞菌中,有37株为多重耐药铜绿假单胞菌,总分离率为33.04%;药物敏感率分析:美罗培南最高,哌拉西林/他唑巴坦次之,头孢哌酮/舒巴坦最小;单因素分析结果显示:多重耐药铜绿假单胞菌院内感染与高龄、入住ICU、并发COPD疾病、长期住院、并发两种及以上细菌感染、使用过碳青霉烯类抗生素和氟喹诺酮药物、机械通气等因素有着密切的关系;多因素分析结果显示:入住ICU、使用过美罗培南/亚胺培南药物、机械通气是多重耐药铜绿假单胞菌院内感染的危险因素。结论医护人员必须要给予无菌操作高度重视,改善住院条件,减少机械通气的使用次数,这样才能有效预防多重耐药铜绿假单胞菌院内感染。
Objective To investigate the risk factors and drug sensitivity of multi-resistant Pseudomonas aeruginosa nosocomial infection. Methods From October 2014 to September 2015, 112 strains of Pseudomonas aeruginosa isolated from Toray Hospital of Dongli District were tested for their sensitivity to eight drugs by standard tablet diffusion method. Meanwhile, Pseudomonas aeruginosa were screened out, using univariate analysis and multivariate analysis, analysis of multi-resistant Pseudomonas aeruginosa infection risk factors. Results Of the 112 strains of Pseudomonas aeruginosa, 37 strains were multi-resistant Pseudomonas aeruginosa with a total separation rate of 33.04%. The drug sensitivity analysis showed that Meropenem was the highest, piperacillin / tazobactam was the second, Cefoperazone / sulbactam was the smallest. The results of univariate analysis showed that the multi-resistant Pseudomonas aeruginosa was associated with nosocomial infection, hospitalized ICU, COPD, long-term hospitalization, two or more bacterial infections, Mycophenolate antibiotics and fluoroquinolone drugs, mechanical ventilation and other factors are closely related; multivariate analysis showed that: occupancy ICU, the use of Meropenem / imipenem drugs, mechanical ventilation is multi-resistant Pseudomonas aeruginosa hospital Risk factors for infection. Conclusion The medical staff must attach great importance to aseptic operation, improve the hospitalization conditions and reduce the number of mechanical ventilation, so as to effectively prevent the multi-drug resistant Pseudomonas aeruginosa nosocomial infection.