Analysis of factors affecting hospital acquired infections and prognosis of carbapenem resistant Pseudomonas aeruginosa

HAN Ping; ZHANG Wei; LEI Chunmei; WANG Bu; ZHAO Jianqing

doi:10.13506/j.cnki.jpr.2025.03.012

Abstract：Objective To analyze the distribution characteristics,nosocomial infection and prognostic factors of carbap-enem resistant Pseudomonas aeruginosa(CRPA)infection.Methods A retrospective study was conducted to collect clinical data of patients first diagnosed with CRPA and carbapenem-sensitive Pseudomonas aeruginosa(CSPA)infection from 2 021 to 2 023 in the First Affiliated Hospital of Hebei North University,with CRPA as the case group(156 cases)and CSPA as the control group(156 cases).Patients with CRPA infection were divided into death group(37 cases)and survival group(119 cases)according to whether they died during hospitalization.SPSS 27.0 statistical software was used to analyze the nosocomial infection and prognostic factors of CRPA,and to compare whether there were differences in in-hospital mortality and 30-day mortality between CRPA and CSPA.Results The most common type of infection in the CRPA and CSPA groups was respira-tory infection,with CRPA concentrated in the intensive care unit(ICU)at 59.0％and CSPA concentrated in general internal medicine at 32.1％.The results of multivariate Logistic regression analysis showed:history of treatment in two or more depart-ments(OR=0.274,95％CI:0.099～0.757,P＜0.05),use of β-lactamase inhibitors(OR=3.065,95％CI:1.734～5.420,P＜0.01)and carbapenem antibiotics(OR=2.329,95％CI:1.217～4.456,P＜0.05)were the independent influencing factors of CRPA nosocomial infection.High serum creatinine[94.20(63.50,282.40);OR=1.005,95％CI:1.001～1.008,P＜0.01]was an independent factor for poor prognosis of CRPA nosocomial infection.In-hospital mortality and 30-day mortality were higher in the CRPA group than in the CSPA group(P＜0.01).Kaplan-Meier curve showed that the 30-day survival time in the CRPA group was shorter than that in the CSPA group(P＜0.01).Conclusion CRPA infection situation is serious,the most common type of infection is respiratory tract infection,and concentrated in ICU.Patients with a history of treatment in two or more de-partments,beta-lactamase inhibitors and carbapenems were more likely to be infected with CRPA,and higher serum creatinine was an independent factor for poor prognosis.In-hospital mortality and 30-day mortality were higher in the CRPA group than in the CSPA group,and 30-day survival was shorter in the CRPA group than in the CSPA group.