院内多重耐药大肠埃希菌肺炎的耐药现状及影像学特征分析

目的 分析院内多重耐药大肠埃希菌(MDR-ECO)肺炎的耐药现状及影像学特征,并探讨发生MDR-ECO感染的危险因素.方法 选择2018-07-01～2020-06-30潍坊市人民医院经呼吸道或者血标本分离检测确认的大肠埃希菌所致院内获得性肺炎(HAP)患者178例的病历资料,根据致病菌是否为多重耐药菌将其分为MDR-...

Current status and imaging characteristics of multidrug-resistant Escherichia coli pneumonia in hospital

Objective To analyze the current status and imaging characteristics of multidrug-resistant Escherichia coli(MDR-ECO)pneumonia in hospital,and to explore the risk factors of MDR-ECO infection.Methods The medical records of 178 patients with hospital acquired pneumonia(HAP)caused by Escherichia coli confirmed by the respiratory tract or blood sample isolation test in Weifang People′s Hospital from July 1,2018 to June 30,2020 were selected.The pathogenic bacteria were divided into MDR-ECO group(153 cases)and non-MDR-ECO group(25 cases)according to whether they were multidrug-resistant bacteria.Their drug resistance and imaging characteristics were analyzed.The risk factors of MDR-ECO infection were investigated by multivariate logistic regression analysis model.Results One hundred and fifty-three strains of MDR-ECO specimens(85.96%)were detected in the 178 specimens.The results of drug susceptibility test showed that the drug resistance rates of MDR-ECO to cefazolin,cefuroxime and penicillins were more than 95%,and the drug resistance rates to gentamicin,aztreonam and ciprofloxacin were more than 50%.The drug resistance rates to ceftazidime and cefotaxime(the third-generation cephalosporins)were 46.41%and 83.01%,respectively,and the drug resistance rate to cefepime(the fourth-generation cephalosporin)was 30.07%.MDR-ECO had the lowest drug resistance rate to ertapenem(0.65%).Compared with the non-MDR-ECO group,the MDR-ECO group has more lesions involving both sides of the lungs,and higher proportions of patchy exudation,consolidation,interstitial changes,cavities and non-nodular lesions,and the differences were statistically significant between the two groups(P<0.05).Multivariate logistic regression analysis showed that co-existing underlying diseases and Intensive Care Unit(ICU)admission were the risk factors of MDR-ECO infection(P<0.05).Conclusion The current status of drug resistance of HAP caused by MDR-ECO is severe.Clinicians should use antibiotics rationally according to the risk factors and imaging characteristics to reduce the production of drug-resistant bacteria.