本文選題：銅綠假單胞菌 + 感染��； 參考：《中華醫(yī)院感染學(xué)雜志》2016年05期

【摘要】：目的通過(guò)薈萃分析探討國(guó)內(nèi)多藥耐藥銅綠假單胞菌(MDRPA)感染的危險(xiǎn)因素,為其感染預(yù)防與控制提供依據(jù)和借鑒。方法通過(guò)計(jì)算機(jī)檢索中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、中國(guó)知網(wǎng)(CNKI)、萬(wàn)方數(shù)據(jù)庫(kù)、維普數(shù)據(jù)庫(kù)(VIP)以及PubMed等數(shù)據(jù)庫(kù),檢索關(guān)于國(guó)內(nèi)MDRPA感染危險(xiǎn)因素的病例對(duì)照研究,檢索時(shí)間均為建庫(kù)至2015年6月,按納入、排除標(biāo)準(zhǔn)由兩人獨(dú)立進(jìn)行文獻(xiàn)篩選、資料提取和質(zhì)量評(píng)價(jià)后,采用RevMan5.0軟件進(jìn)行薈萃分析。結(jié)果納入研究共6個(gè),MDRPA感染患者345例,銅綠假單胞菌敏感菌株感染患者851例,薈萃分析結(jié)果顯示,入住ICU/RCU、患有支氣管擴(kuò)張/慢性阻塞性肺疾病、混合感染、留置胃管、氣管切開(kāi)/插管、機(jī)械通氣及感染前使用三、四代頭孢菌素、喹諾酮類及碳青霉烯類抗菌藥物、聯(lián)用兩類或兩種抗菌藥物、聯(lián)用3類或3種抗菌藥物等因素,MDRPA感染患者中比例明顯高于PAE敏感患者;MDRPA感染患者感染前僅使用1類或1種抗菌藥物的比例明顯低于PAE敏感患者;MDRPA耐藥性分析發(fā)現(xiàn),耐藥率最高的是慶大霉素和環(huán)丙沙星。結(jié)論 MDRPA感染與多個(gè)因素相關(guān),臨床醫(yī)師應(yīng)注意相關(guān)危險(xiǎn)因素,合理使用抗菌藥物,避免患者發(fā)生MDRPA感染。
[Abstract]:Objective to explore the risk factors of multidrug resistant Pseudomonas aeruginosa (MDRPA) infection in China by meta-analysis, and to provide reference for the prevention and control of MDRPA infection. Methods the database of Chinese biomedical literature (CBM), CNKIX, Wanfang database, Weip database and PubMed were searched by computer, and case-control studies on the risk factors of MDRPA infection in China were searched. The retrieval time is from the establishment of the database to June 2015. According to the inclusion and exclusion criteria, the documents are screened independently by two people. After the data is extracted and the quality is evaluated, the meta-analysis is carried out by using RevMan5.0 software. Results A total of 345 patients with MDRPA infection and 851 patients with Pseudomonas aeruginosa susceptible strains were included in the study. The results of meta-analysis showed that ICU / RCUpatients had bronchiectasis / chronic obstructive pulmonary disease, mixed infection, and gastric tube indwelling. Tracheotomy / intubation, mechanical ventilation and use of third or fourth generation cephalosporins, quinolones and carbapenes before infection, combined with two or two kinds of antimicrobial agents, The proportion of MDRPA-infected patients with MDRPA was significantly higher than that of MDRPA-sensitive patients with PAE before infection. The proportion of MDRPA-positive patients who only used class 1 or 1 antibiotics before infection was significantly lower than that of PAE sensitive patients. The highest drug resistance rates were gentamicin and ciprofloxacin. Conclusion MDRPA infection is related to many factors. Clinicians should pay attention to the related risk factors and use antibiotics rationally to avoid MDRPA infection.
【作者單位】： 上海市南翔醫(yī)院感染管理科;上海市南翔醫(yī)院醫(yī)學(xué)檢驗(yàn)科;復(fù)旦大學(xué)附屬中山醫(yī)院感染管理科;
【基金】：中華醫(yī)院感染基金資助項(xiàng)目(ZHYY2013-022) 上海市嘉定區(qū)科學(xué)技術(shù)委員會(huì)基金資助項(xiàng)目(2014-KW-15)
【分類號(hào)】：R446.5
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本文編號(hào)：1941033