摘要
目的:分析临床分离的哌拉西林/他唑巴坦(PIP-TAZ)耐药大肠埃希菌(E.coli)感染的预后及危险因素。方法:回顾研究2011年1至12月临床分离的825株E.coli对PIP-TAZ的耐药率及感染患者的预后,以PIP-TAZ敏感大肠埃希菌为对组,对PIP-TAZ耐药大肠埃希菌感染危险因素进行分析。结果:825株大肠埃希菌中,86株为PIP-TAZ耐药株,其中38株产超广谱β-内酰胺酶,48株产高水平的青霉素酶。Logistic回归分析显示阿莫西林或阿莫西林/克拉维酸使用(OR=2.058,95%CI为1.237～3.430)和ICU入住比例(OR=1.871,95%CI为1.051～3.329)是PIP-TAZ耐药E.coli感染的重要危险因素。哌拉西林/他唑巴坦耐药株感染或定植患者病死率与敏感株间差异无统计学意义(P>0.05)。PIP-TAZ耐药大肠埃希菌感染患者的平均住院时间明显长于敏感株(t=14.1,P<0.05)。结论:ICU入住比例和阿莫西林或阿莫西林/克拉维酸的使用是PIP-TAZ耐药大肠埃希菌感染的危险因素。
Objective To investigate the clinical outcome and risk factors of piperacillin / tazobactam(PIP-TAZ) resistant Escherichia coli isolated from the hospital.Methods This study was a retrospective review of a hospital epidemiology data base and includes 825 strains of E.coli isolated from clinical specimens.PIP-TAZ-sensitive Escherichia coli were as control,the risk factors for PIP-TAZ-resistant were analyzed.Results Among 825 strains E.coli,86 strains were PIP-TAZ-resistant,38 strains produced an extended spectrum β-lactamase,48 strains produced a high level penicillinase.Logistic regression analysis showed that the application of amoxicillin or amoxicillin / clavulanic acid(OR=2.058,95%CI was 1.237~3.430) and ICU occupancy rate(OR=1.871,95%CI was 1.051~3.329 PIP-TAZ) were independent risk factors for PIP-TAZ resistance E.coli.Mortality were similar between PIP-TAZ-resistant isolates and with PIP-TAZ-sensitive isolates(P>0.05).Length of stay in hospital are longer in patients with infections with PIP-TAZ-resistant isolates than sensitive isolates(t=14.1,P<0.05).Conclusion The use of Amoxicillin or amoxicillin / clavulanic acid and ICU occupancy rate are independent risk factors for PIP-TAZ-resistant E.coli.
出处
《湖北医药学院学报》
CAS
2012年第3期233-236,共4页
Journal of Hubei University of Medicine
