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目的 研究重症监护病房(ICU)铜绿假单胞菌感染的发生率、危险因素及耐药情况.方法 收集171例脓毒症患者,分离培养铜绿假单胞菌并进行药敏试验.采用SPSS10.0统计学软件对可能的危险因素进行Logistic回归分析.结果 171例脓毒症患者中,发生铜绿假单胞菌感染37例,分离培养出 45株铜绿假单胞菌.多因素Logistic回归分析显示,近期抗菌药物使用史(OR=4.291,95%CI:1.727～10.662)、住ICU时间(OR=1.117,95%CI:1.058～1.181)、机械通气(OR=3.400,95%CI:1.348～8.579)以及中心静脉导管的使用(OR=3.339,95%CI:1.322～8.434)为铜绿假单胞菌感染的独立危险因素.药敏试验显示铜绿假单胞菌对头孢寨肟的耐药率最高(68.9%),18株(40%)菌株表现为多重耐药.结论 铜绿假单胞菌足ICU常见的病原菌,具有多重耐药性.加强抗菌药物的合理使用、严格执行各种有创导管的无菌操作是减少铜绿假单胞菌耐约的重要措施.

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.