Study on clinical characteristics and risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae
ZHOU Yanjun1 JIA Xiaojiong1 HE Jianchun1 XIA Yun2
1.The First Clinical College of Chongqing Medical University, Chongqing 400016, China;
2.Department of Laboratory, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Abstract：Objective To investigate clinical characteristics and risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae. Methods By means of case-control study, a total of 138 strains of Enterobacter cloacae isolated from the aseptic fluid samples of hospitalized patients from the First Affiliated Hospital of Chongqing Medical University from January 2014 to December 2016 were collected. Imipenem-resistant strains of Enterobacter cloacae were used as experimental group (115 strains) and non-heterogeneous drug-resistant strains as control group (23 strains). The disk diffusion was used for screening heteroresistance and PAP test confirmed the heteroresistance. The risk factors of patients'case data were analyzed by statistical method. Results There were 115 strains (83.3%) showed heteroresistance to imipenem. The rate of separation of hepatobiliary department was 34.1%. From the type of isolated specimens, most of them were derived from blood samples and the isolation rate was 35.5%. The results of multivariate analysis showed that male (OR = 3.40, 95%CI: 1.16-9.92), catheter (OR = 3.74, 95%CI: 1.25-11.24), central venous catheter (OR = 3.65, 95%CI: 1.22-10.89) and use of carbapenem antibiotics (OR = 6.79, 95%CI: 1.48-31.14) were independent risk factors for infection of Imipenem-heteroresistant Enterobacter cloacae (P < 0.05). Conclusion Clinical indications for antimicrobial agents should be strictly controlled and invasive procedures should be regulated to reduce the emergence and prevalence of heteroresistant bacteria.
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2019, Vol. 16 
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