Risk factors and drug-resistance of Pseudomonas aeruginosa infection in intensive care unit

( views:176, downloads:0 )
Author:
HE Xin-biao(Emergency Center, the Second Hospital of Tianjin Medical University, Tianjin 300211,China)
ZHAO Wei()
Journal Title:
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
Issue:
Volume 04, Issue 03, 2011
DOI:
10.3760/cma.j.issn.1674-2397.2011.03.003
Key Word:
Pseudomonas aeruginosa;Drug resistance;Risk factor

Abstract: Objective To investigate the incidence, risk factors and drug-resistance of Pseudomonas aeruginosa infection in intensive care unit (ICU). Methods Totally 171 patients with sepsis admitted in ICU were enrolled. Pathogenic bacteria culture and antimicrobial susceptibility tests were performed. SPSS10. 0 software was used for Logistic regression analysis of the risk factors. Results Pseudomonas aeruginosa infection was confirmed in 37 patients, and 45 strains of Pseudomonas aeruginosa were isolated. Logistic regression revealed that recent antibiotics use ( OR = 4. 291 , 95% CI: 1. 727-10. 662) , length of ICU stay (OR = 1.117, 95% CI: 1.058-1. 181) , mechanical ventilation (OR = 3.400, 95% CI: 1.348-8.579) and central venous catheterization (OR =3. 339, 95% CI: 1.322-8.434) were independent risk factors of Pseudomonas aeruginosa infection. The resistance rate of cefotaxime was the highest (68.9%) and 18 strains (40%) were multidrug-resistant. Conclusions Pseudomonas aeruginosa infection is common in ICU and it is usually multidrug resistant. The rational use of antibiotics and aseptic technique of invasive catheterization are important for the prevention of Pseudomonas aeruginosa infection.

  • [1]姚咏明,盛志勇,林洪远,等.脓毒症定义及诊断的新认识.中国危重病急救医学,2004,16(6):321-324.
  • [2]马越,李景云,金少鸿.美国临床实验室标准委员会推荐药敏试验操作方法和判断标准(2005年修订版).中华医学杂志,2005,85(17):1182-1184.
  • [3]Kerr KG,Snelling AM.Pseudomonas aeruginosa:a formidable and ever-present adversary.J Hosp Infect,2009,73(4):338-344.
  • [4]Cheonq HS,Kang CI,Wi YM,et al.Inappropriate initial antimicrobial therapy as a risk factor for mortality in patients with community-onset Pseudomonas aeruginosa bacteraemia.Eur J Clin Microbiol Infect Dis,2008,27(12):1219-1225.
  • [5]Kaye KS,Kanafani ZA,Dodds AE,et al.Differential effects of levofloxacin and ciprofloxacin on the risk for isolation of quinoloneresistant Pseudomonas aeruginosa.Antimicrob Agents Chemother,2006,50(6):2192-2196.
  • [6]Cezário RC,Duarte De Morals L,Ferreira JC,et al.Nosocomial outbreak by imipenem-resistant metallo-beta-lactamase-producing Pseudomonas aeruginosa in an adult intensive care unit in a Brazilian teaching hospital.Enferm Infect Microbiol Clin,2009,27(5):269-274.
  • [7]Tam VH,Chang KT,Larocco MT,et al.Prevalence,mechanisms and risk factors of carbapenem resistance in bloodstream isolated of Pseudomonas aeruginosa.Diagn Microbiol Infect Dis,2007,58 (3):309-314.
  • [8]Depuydt PO,Vandijck DM,Bekaert MA,et al.Determinants and impact of multidrug antibiotic resistance in pathogens causing ventilator-associated-pneumonia.Crit Care,2008,12(6):142-150.
  • [9]Roche O,Beuhorry SF,Boillot A,et al.Pseudomonas aeruginosa septicemia.Host-related risk factors in 82 episodes.Presse Med,1995,24(25):1164-1166.
  • [10]Hota S,Hiriji Z,Stockton K,et al.Outbreak of multidrugresistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design.Infect Control Hosp Epidemiol,2009,30(1):25-33.
  • [11]Valerie A,Shiri NV,Yardena SI,et al.Multidrug-resistant Pseudomonas aeruginosa:risk factors and clinical impact.Antimicrob Agent Chemother,2006,50(1):43-48.
  • [12]徐黔宁,王伟平,张仙森.铜绿假单胞菌感染分析及药敏分析.中华医院感染学杂志,2005,15(2):213-214.
  • [13]Tsuchimochi N,Takuma T,Shimono N,et al.Antimicrobial susceptibility and molecular epidemiological analysis of clinical strains of Pseudomonas aeruginosa.J Infect Chemother,2008,14 (2):99-104.
  • [14]Pappas G,Saplaonra K,Falagas ME.Current treatment of pseudomonal infections in the elderly.Drugs Aging,2009,26 (5):363-379.
  • [15]Mueller MR,Hayden MK,Fridkin SK,et al.Nosocomial acquisition of Pseudomonas aeruginosa resistant to both ciprofloxacin and imipenem:a risk factor and laboratory analysis.Eur J Clin Microbiol Infect Dis,2008,27(7):565-570.
  • [16]彭少华,金正江,罗兰,等.耐亚胺培南铜绿假单胞菌致医院感染危险因素的病例对照研究.中华流行病学杂志,2005,26(7):511-514.
  • [17]Lautenbach E,Synnestvedt M,Weiner MG,et al.Imipenem resistance in Pseudomonas aeruginosa:emergence,epidemiology,and impact on clinical and economic outcomes.Infect Control Hosp Epidemiol,2010,31(1):47-53.
  • [18]Furtado GH,Berqamasco MD,Menezes FG,et al.Imipenemresistant Pseudomonas aeruginosa infection at a medical-surgical intensive care unit:risk factors and mortality.J Crit Care,2009,24(4):9-14.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn