Drug resistance and antimicrobial therapeutic efficacy of Pseudomonas aeruginosa in pulmonary infection

Abstract:

ObjectiveTo analyze drug resistance and distribution of integron in Pseudomonas aeruginosa (P. aeruginosa) isolated from patients with pulmonary infection, and evaluate antimicrobial therapeutic efficacy and influencing factors.MethodsClinical data of 114 patients with P. aeruginosa pulmonary infection in a hospital between September 2008 and December 2010 were reviewed retrospectively. P. aeruginosa isolated from above patients were performed antimicrobial susceptibility testing; the segments of integron were amplified by polymerase chain reaction; risk factors influencing the prognosis of P.aeruginosa pulmonary infection were analyzed.ResultsA total of 114 P. aeruginosa isolates were collected, 47(41.23%) were multidrugresistant strains; 71 (62.28%) were detected class Ⅰ integron. Patients’ prognosis were as follows:21 (18.42%) were cured, 63(55.26%) were improved, and 30(26.32%) died. Except gentamycin, amikacin, tobramycin, piperacillin and piperacillin/tazobactam, drug resistance rate of class Ⅰ integron positive strains was obviously higher than class Ⅰ integron negative strains(P<0.05). Factors influencing the prognosis of P.aeruginosa pulmonary infection included positive class Ⅰ integron,multidrugresistant strain, inappropriate empirical therapy, combination use of three or more types of antimicrobial agents,mixed infection and use of carbapenems, but combination use of two types of antimicrobial agents was the protective factor for prognosis.ConclusionMultidrug resistance rate and positive rate of class Ⅰ integron of P.aeruginosa are relatively high in pulmonary infection patients, integron is closely related to drug resistance, it is necessary to strengthen surveillance. Be sure to avoid using carbapenem for empirical treatment; combination of two types of antimicrobial agents for antiinfection treatment is recommended.