| Objective Through the analysis of CRPA infection patients,we can clarify the epidemic trend of CRPA infection,clinical characteristics,specimen sources,department distribution,past medical history,medication history,and the resistance of CRPA to other antimicrobial drugs from different specimen sources,which could provide reference for clinical treatment of CRPA.Methods We collected 7630 positive specimens of Pseudomonas aeruginosa at the First Hospital of Jilin University from November 2015 to October 2019.728 specimens resistant to both meropenem and imipenem were screened out.There are total 373 cases were studied,for the specimens that are repeatedly cultured positive in the same site for the same patient,just for one case.We aimed to summarize its clinical characteristics and analyze the resistance of these CRPA-infected patients to other antibacterial drugs.The count data conforming to the normal distribution are represented by the mean ± standard deviation,and others are represented by the median(upper quartile,lower quartile),Using Kruskal-Wallis H test for non-normally distributed data.R×C chi-square test or Fisher’s exact probability method were used for the compari- son of the detection rate,and P<0.05 is considered statistically different.Result 1.The detection rates of CRPA-infected patients in the past 4 years were 10.76%,8.96%,8.0%,and 8.33%.2.373 cases of CRPA infection included 278 males(74.53%)and 95 females(25.47%).The ratio of male to female was 2.9:1.The average age is 58±16 years.3.Most of CRPA infections were from ICU(110 cases,29.49%),and 280 cases(75.07%)were mainly from sputum samples.The median length of hospital stay was 34(20,58)days.Among them,burn patients had a longer hospital stay.4.Most people infected with CRPA have basic respiratory diseases and hypoproteinemia.5.Three months before the CRPA culture was positive,261 patients(69.97%)had used carbapenems,and the most commonly used regimens were carbapenems and cephalosporins.6.The resistance rates of 373 CRPA strains to other antibacterial drugs in descending order are: ciprofloxacin(45.04%),cefepime(38.07%),piperacillin/tazobactam(35.66%),ceftazidime(32.17%),levofloxacin(28.15%),amikacin(8.85%).7.CRPA from different specimen sources has different resistance rates to levofloxacin.Among them,CRPA resistance rate in pus is higher(60%),CRPA resistance rate in bile is lower(12.5%),and the difference is statistically significant(P=0.00).Conclusion 1.The CRPA detection rate in our hospital has a downward trend.2.CRPA-infected patients are mainly males.Most of patients come from ICU,with respiratory specimens as the main source.3.CRPA-infected patients have multiple underlying diseases,and most of them have used multiple antibacterial drugs including carbapenems within 3 months.4.CRPA has the highest resistance rate to ciprofloxacin and the lowest resistance rate to amikacin;Levofloxacin can be considered to treat CRPA infection of the biliary tract. |
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