某三甲医院耐碳青霉烯类铜绿假单胞菌感染患者的临床特征及危险因素

Clinical Characteristics and Risk Factors of Carbapenem-Resistant Pseudomonas Aeruginosa Infection in a Tertiary Hospital

摘要: 目的：探讨某三甲医院耐碳青霉烯类铜绿假单胞菌感染患者的临床特征及危险因素。方法：回顾性分析2017年10月~2022年10月某三甲医院住院治疗的52例CRPA患者的临床资料及菌株药敏数据，分析结果差异、临床特征和危险因素。结果：52例CRPA感染患者中，男性38例(73.08%)，男女比例为2.7:1；平均年龄65 ± 14岁；科室最常见于呼吸与危重症医学科17例(32.69%)，其次是重症医学科12例(23.08%)；标本主要来源于痰液40例(76.92%)；对于基础疾病，合并贫血患者36例(69.23%)，呼吸系统疾病34例(65.38%)，心脑血管系统疾病30例(57.69%)；近2月抗生素的使用情况，使用碳青霉烯类抗生素的有34例(65.38%)；半合成β内酰胺酶复合制剂31例(59.62%)；52株CRPA中耐药率 ≥ 50%的抗菌药物从高到低依次为亚胺培南、美洛培南，多粘菌素是耐药率最低且药物敏感率最高的抗菌药物。结论：52例CRPA患者表明男性患者、住院时间过长、合并贫血及呼吸系统疾病、近2月内碳青霉烯类抗菌药物应用史均会增加感染耐药菌的风险，控制危险因素、缩短住院时长以及合理应用抗生素可以减少多重耐药菌感染。

Abstract: Objective: The objective of this study was to investigate the clinical features and risk factors associated with carbapenem-resistant pseudomonas aeruginosa (CRPA) infection in a tertiary hospital. Methods: Retrospective analysis was conducted on the clinical and bacterial susceptibility data of 52 CRPA-infected patients hospitalized from October 2017 to October 2022. Results: Clinical characteristics and risk factors were analyzed for differences. Among the 52 CRPA-infected patients, 38 (73.08%) were male with a male-to-female ratio of 2.7:1. The average age was 65 ± 14 years, the department is most commonly found in the Respiratory and Critical Care Medicine department with 17 cases (32.69%), followed by the Intensive Care Medicine department with 12 cases (23.08%). Sputum was the primary source of infection in 40 cases (76.92%). Underlying diseases included anemia in 36 cases (69.23%), respiratory diseases in 34 cases (65.38%), and cardiovascular/cerebrovascular diseases in 30 cases (57.69%). Within the past two months, carbapenem antibiotics were used by 34 cases (65.38%). Semi-synthetic β-lactamase compound preparations were used by 31 cases (59.62%). Amongst the 52 strains of CRPA, the antibiotics with resistance rate ≥ 50% were imipenem and meropenem from high to low, and polymyxin was the antibiotic with the lowest resistance rate and the highest sensitivity rate. Conclusion: The findings from this study indicate that male gender, longer hospital stays, anemia, respiratory diseases, and recent use of carbapenem antibiotics are all associated with an increased risk of drug-resistant bacterial infections. Controlling these risk factors, reducing hospital stays, and using antibiotics rationally could help mitigate multi-drug resistant bacteria infections.