Study on the risk factors of multiple drug-resistant Pseudomonas aeruginosa infection and the rational use of antimicrobial agents

Objective To investigate the risk factors and drug-resistance of Pseudomonas aeruginosa in nosocomial infections and provide the scientific evidence for the clinical use of the antibiotics. Methods A total of 586 strains of Pseudomonas aeruginosa isolated from clinical specimens were conducted drug sensitivity test by using 96NE plate from Black Madill's company, and the drug resistance of these strains were analyzed. The statistical analyses of the single factor analysis(χ2and t test) and multivariate logistic regression methods were used to analyze the risk factors of multidrug drug-resistant Pseudomonas aeruginosa infection. Results There were 84 strains of multidrug resistant Pseudomonas aeruginosa in the 586 strains of Pseudomonas aeruginosa, which accounted for 14.3%. Previous treatment in the ICU, mechanical intervention procedures, and the use of carbapenem antibiotics were the independent risk factors of infection of multiple drug resistant Pseudomonas aeruginosa. Among the 12 kinds of antibiotics, the drug-resistance rate of multiple drug-resistance Pseudomonas aeruginosa to cefoperazone/sulbactam was the lowest(27.4%). And the drug-resistance rate to gentamicin and ciprofloxacin were 90.5% and 92.9%, respectively, which were the highest. The drug resistance rate of multiple drug-resistance Pseudomonas aeruginosa to ceftazidime fell from 61.5% in 2008 to 39.1% in 2012. And the drug-resistance rates to imipenem, meropenem and ticarcillin/clavulanic increased from 38.5%, 38.5% and 46.2% in 2008 to 52.2%, 52.2% and 78.3% in 2012, respectively. Conclusions The drug-resistance rates of multiple drug-resistance Pseudomonas aeruginosa are very serious. In order to reduce and control the occurrence of multiple drug-resistance bacteria, clinician should use antibiotics rationally according to the results of drug susceptibility test and pay attention to the various risk factors of multiple drug- resistant Pseudomonas aeruginosa infection.