Implementing antimicrobial management toimprove susceptibility of Pseudom onas aeruginosa to carbapenems
10.3969/j.issn.1671-9638.2018.04.007
- VernacularTitle:实施抗菌药物管理提高铜绿假单胞菌对碳青霉烯类药物的敏感性
- Author:
Yao WANG
1
;
Hong-Zhi WANG
;
Qi LI
;
Lin-Juan LIU
;
Guang-Fa WANG
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所 恶性肿瘤发病机制及转化研究教育部重点实验室
- Keywords:
Pseudomonas aeruginosa;
carbapenem;
antimicrobial agent;
classified management system;
antimi-crobial management
- From:
Chinese Journal of Infection Control
2018;17(4):310-315
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze susceptibility of clinically isolated Pseudomonas aeruginosa(PA)to carbape-nems,and observe the effect of classified management of antimicrobial agents on carbapenem susceptibility.Methods PA isolated from Peking University Cancer Hospital between October 2012 and March 2014 were collected,uni-variate analysis and multivariate logistic regression analysis were adopted to study the risk factors for non-suscepti-bility to carbapenems,susceptibility of PA to carbapenems before and after the implementation of classified manage-ment of antimicrobial agents was analyzed.Results A total of 125 strains of PA were isolated,mainly from patients with esophageal cancer(n=30,24.0%)and colorectal cancer(n=29,23.2%);the main specimens were drainage fluid and wound secretion(n=62,49.6%);the main source departments were surgical wards(n=86,68.8%). Univariate analysis showed that non-susceptibility of PA to carbapenems was related to strains from surgical wards,hospitalization within 3 months,carbapenem exposure,and length of hospital stay>4 weeks. Logistic regression analysis showed that 3 independent risk factors were:strains from surgical wards,exposure to carbapenems,and length of hospital stay>4 weeks. Susceptibility of PA to carbapenems after implementation of antimicrobial man-agement was 74.6%,which was higher than 53.4% before management(P= 0.015).Conclusion Strains from surgical wards,carbapenem exposure,and length of hospital stay>4 weeks are independent risk factors for no-sus-ceptibility of PA to carbapenems;susceptibility of PA to carbapenems is increased after strict implementation of antimicrobial classified management system.
