Analysis On The Pseudomonas Aeruginosa Infection Risk Factors In Patients With Urinary System Catheter And Its Drug Resistance Status

Objective: To analyze the risk factors of Pseudomonas aeruginosa infection in patients with urinary tract and to explore the drug resistance in patients infected with Pseudomonas aeruginosa.Methods: Two thousand and twelve cases of patients received urinary catheterization in our hospital from January 2015 to January 2017 were enrolled,the occurrence of 62 case of pseudomonas aeruginosa infection were observed and the drug resistant situation was analyzed.Univariate analysis(?~2 test)and multivariate logistic regression methods were applied to analyze the risk factors of Pseudomonas aeruginosa infection.Results: Univariate analysis and multivariate logistic regression analysis showed that patients who were over 60 years of age(vs less than or equal to 60 years old)OR = 3.041,95% CI(1.623-5.699),had a retention time of more than 1 month(VS retention time less than or equal to 1 month)OR = 2.889,95% CI(1.380-6.048),preoperative renal impairment(VS without renal dysfunction before surgery)OR = 7.111,95% CI(3.470-14.575),combined with hypoproteinemia(VS the basic history of diabetes mellitus)OR = 4.303,95% CI(1.416-13.074),in vitro infection(VS in vivo catheterization)OR = 12.987,95% CI(6.667-25.000),were the independent risk factors of Pseudomonas aeruginosa infection.Infection rate of Pseudomonas aeruginosa between three kinds of external drainage were tested by Chi-square test and split chi-square test.To compared with indwelling catheterization group(?~2=15.26,P=0.000)and bladder fistula drainage group(?~2=18.41,P=0.000),the infection rate was higher in indwelling nephrostomy group.Bacterial culture and drug sensitivity test confirms: Commonly used 20 kinds of antibiotic susceptibility test report shows that cefuroxime(resistance 100%),cefuroxime sodium(resistance 98%),cefuroxime axetil(resistance 98%),ceftriaxone(resistance 98%)in cephalosporin;ampicillin(resistance 100%),ampicillin/sulbactam(resistance 100%)in penicillin;cefotetan(resistance 90%)in other ?-lactam;nitrofurantoin(resistance 90%)in nitrofuran and compound neoproxen(resistance 98%)in sulfonamides were resistant factors to Pseudomonas aeruginosa.Aminoglycoside the amikacin(94% sensitivity),gentamicin(sensitivity 71%),tobramycin(sensitivity 77%)in aminoglycoside ciprofloxacin(61%sensitivity),levofloxacin(65%sensitivity)in quinolones;ceftazidime(sensitivity 84%),cefule(Sensitivity 80%)in cephalosporin,piperacillin/tazobactam(sensitivity 80%),oxypiperazine penicillin(sensitivity 74%)in semi-synthetic penicillin;and merlot(77% sensitivity),imipramine(Thai)(sensitivity 94%)in Carbohydrin were sensitive to Pseudomonas aeruginosa.Conclusion: The elderly(more than 60 years old),combined with impaired renal function,hypoproteinemia,diabetes are high-risk groups of Pseudomonas aeruginosa infection with urinary tract,especially whose urinary system was once established outside the drainage tube(especially indwelling nephrostomy),more than a month,the rate of Pseudomonas aeruginosa infection was significantly increased.Because drug resistance to Pseudomonas aeruginosa infection is extremely severe,antibiotics should be rationally applied according to the results of drug susceptibility test and the various risk factors of Pseudomonas aeruginosa infection should be taken into consideration as well.