中国感染控制杂志2013，Vol.12Issue(2)：92-96,5.DOI:10.3969/j.issn.1671-9638.2013.02.004
肺部感染铜绿假单胞菌耐药性与抗菌药物治疗效果研究
Drug resistance and antimicrobial therapeutic efficacy of Pseudomonas aeruginosa in pulmonary infection
摘要
Abstract
Objective To analyze drug resistance and distribution of integron in Pseudomonas aeruginosa (P. aeruginosa) isolated from patients with pulmonary infection, and evaluate antimicrobial therapeutic efficacy and influencing factors. Methods Clinical data of 114 patients with P. aeruginosa pulmonary infection in a hospital between September 2008 and December 2010 were reviewed retrospectively. P. aeruginosa isolated from above patients were performed antimicrobial susceptibility testing; the segments of integron were amplified by polymerase chain reaction; risk factors influencing the prognosis of P. aeruginosa pulmonary infection were analyzed. Results A total of 114 P. aeruginosa isolates were collected, 47(41. 23%) were multidrug-resistant strains; 71 (62. 28%) were detected class 1 integron. Patients7 prognosis were as follows;21 (18. 42%) were cured, 63(55. 26%) were improved, and 30(26. 32%) died. Except gentamycin, amikacin, tobramycin, piperacillin and piperacillin/tazobac-tam, drug resistance rate of class 1 integron positive strains was obviously higher than class 1 integron negative slrains(P＜0. 05). Factors influencing the prognosis of P. aeruginosa pulmonary infection included positive class 1 integron,multidrug-resistant strain, inappropriate empirical therapy, combination use o[ three or more types of antimicrobial agents,mixed infection and use of carbapenems, but combination use of two types of antimicrobial agents was the protective factor for prognosis. Conclusion Multidrug resistance rate and positive rate of class ⊥ integron of P. aeruginosa are relatively high in pulmonary infection patients, integron is closely related to drug resistance, it is necessary to strengthen surveillance. Be sure to avoid using carbapenem for empirical treatment; combination of two types of antimicrobial agents for anli--mfection treatment is recommended.关键词
铜绿假单胞菌/肺部感染/抗药性,微生物/整合子/抗菌药物Key words
Pseudomonas aeruginosa / pulmonary infection/ drag resistance, microbial/ integron/ antimicrobial agent分类
医药卫生引用本文复制引用
毕嘉琦,周俊立,陈小凤,彭洋,姚振江..肺部感染铜绿假单胞菌耐药性与抗菌药物治疗效果研究[J].中国感染控制杂志,2013,12(2):92-96,5.基金项目
广东省科技厅计划项目(2008B030301034)广东药学院科学基金(2006GW002)广东省教育厅大学生创新实验项目(1057310002) （2008B030301034）
