Analysis Of The Resistance Characteristics And Influencing Factors Of Pseudomonas Aeruginosa In Lower Respiratory Tract In A Respiratory Hospital In Nanchang

Objective:To obtain the resistance characteristics and trends of Pseudomonas aeruginosa isolated from the lower respiratory tract in Jiangxi Chest Hospital(Respiratory Specialist Hospital)from 2013 to 2017,to analyze the characteristics and influencing factors of multi-drug resistance and extensively drug-resistant Pseudomonas aerugi-nosa(MDR/XDR-PA)in the hospital.Method:1110 strains of Pseudomonas aeruginosa were isolated from the lower respiratory tract of hospitalized patients from January 2013 to December 2017 in Jiangxi Chest Hospital,and the same results of drug susceptibility test obtained by the same location of one patient during one hospitalization period were excluded.To analyze the resistance characteristics and trends of Pseudomonas aeruginosa,and the characteristics and influencing factors of multi-drug resistance and extensively drug-resistant Pseudomonas aeruginosa.A total of 370 cases of Pseudomonas aeruginosa were selected through System sampling.After collecting basic information,the influencing factors of multiple drug resistant bacteria were analyzed by single factor and multiple factor analysis.All datas were processed by SPSS20.0software,(49)<0.05 was considered statistically significant.Results:A total of 1110 strains of Pseudomonas aeruginosa were isolated,which were mainly from sputum samples,accounting for 95.14%,followed by brush samples of1.98%,pleural fluid of 1.62%and alveolar lavage fluid of 1.26%.The 1110specimens were mainly from the respiratory department,accounting for 45.14%,followed by 13.99%in cardiology department,12.88%in tuberculosis department,9.82%in thoracic surgery department,7.39%in ICU,5.67%in neurology department and 5.41%in oncology department.1.Among the commonly used antibacterial drugs in clinical practice,the most sensitive drug to Pseudomonas aeruginosa is cefoperazone/sulbactam,followed by piperacillin/tazobactam,amikacin,imipenem,ceftazidime and cefepime;the highest resistant drug was levofloxacin,followed by ticarcillin/clavulanic acid,ciprofloxacin,and aztreonam with the drug resistance rate exceeded 30%.In the trend chi-square test for the commonly used antibiotic resistance,levofloxacin,ticarcillin/clavulanic acid,ciprofloxacin,gentamicin,ceftazidime,piperacillin/tazobactam,cefoperazone/sulbactam were associated with years((49)<0.05),and there was no obvious correlation between antibiotics like imipenem,amikacin,aztreonam,oxypiperazine and cefepi-me and the age((49)>0.05).2.The multiple drug resistance rate of Pseudomonas aeruginosa was accounting for 38.02%from 2013 to 2017,and there was no statistically significant difference in the multiple drug resistance rate of each year(?~2=6.634,(49)<0.157).3.The generation of multi-drug resistant strains were not associated with the patient’s gender,duration of disease,bronchodilation,congenital pulmonary hypoplasia,bronchial asthma,tumor,brain Vascular disease,kidney disease,diabetes,tuberculosis infecting,malnutrition,respiratory surgerying history,tracheal intubation,times and days of hospitalization((49)>0.05),but positively correlated with age,chronic obstructive pulmonary disease(COPD),smoking history and pre-hospital antibiotic using((49)<0.05).Logistic regression analysis showed that age,COPD and pre-hospital antibiotic using were closely related to MDRPA infection.Conclusion:1.Pseudomonas aeruginosa isolated from 2013 to 2017 increased year by year except 2015,and mainly from the respiratory department.2.The detection rate of multi-drug resistance and extensively drug-resistant Pseudomonas aeruginosa in the hospital was high.3.The generation of multi-drug resistant strains was positively correlated with age,COPD and pre-hospital antibiotic using.