某县级医院铜绿假单胞菌的分布及耐药性变迁

Distribution and antimicrobial resistance of Pseudomonas aeruginosa in a countylevel hospital

摘要:

目的了解近年某县级医院铜绿假单胞菌的分布及耐药特点，为临床合理用药提供依据，并有助于医院感染预防与控制。方法对该院2010—2012年临床各类标本分离的铜绿假单胞菌的资料进行统计分析。结果3年共分离铜绿假单胞菌369株，主要检出自痰液及咽拭子（234株，63.41%）、尿液（41株，11.11%）和伤口拭子（28株，7.59%）标本；在病区，主要分布于重症监护室（146株，39.56%）、呼吸内科（51株，13.82%）和神经外科（37株，10.03%）。铜绿假单胞菌对多粘菌素B无耐药；对亚胺培南、美罗培南、头孢哌酮／舒巴坦、哌拉西林／他唑巴坦和阿米卡星的耐药率较低（6.81%～22.73%）；各年度相比，除多粘菌素B外，对其他抗菌药物的耐药率均有不同程度上升，部分抗菌药物具统计学意义（P＜0.05）。结论该院铜绿假单胞菌主要分离自呼吸道标本，以收治危重症患者的科室分布较多；对多种抗菌药物具有较高的耐药性，且有上升趋势，临床应加强监控。

关键词:

铜绿假单胞菌; 抗菌药物; 抗药性，微生物; 耐药; 医院感染; 合理用药

Abstract:

ObjectiveTo analyze the distribution and antimicrobial resistance of Pseudomonas aeruginosa(P. aeruginosa) in a countylevel hospital, provide reference for rational antimicrobial use, and promote the control and prevention of healthcareassociated infection (HAI).MethodsData of P. aeruginosa isolated from patients in a hospital between 2010 and 2012 were analyzed statistically.ResultsA total of 369 P. aeruginosa isolates were isolated, strains were mainly from specimens of sputum（n=234，63.41%）,urine（n=41，11.11%）and wound（n=28，7.59%）; most strains were from intensive care unit（n=146，39.56%）,respiratory diseases department（n=51，13.82%）and neurosurgical department（n=37，10.03%）. P. aeruginosa strains were not resistant to polymyxin B;the resistance rates to imipenem, meropenem, cefoperazone / sulbactam, piperacillin / tazobactam and amikacin were all low(6.81%-22.73%); from 2010 to 2012, resistance rates to antimicrobial agents (except polymyxin B) increased with varying degrees, some antimicrobial agents showed statistical difference（P＜0.05）.ConclusionP.aeruginosa is mainly isolated from respiratory specimens, mainly distributed in departments with serious patients; and resistance to most antimicrobial agents is high, resistance tendency is increasing, surveillance should be intensified.

Key words:

Pseudomonas aeruginosa; antimicrobial agent; drug resistance, microbial; drug resistance; healthcareassociated infection; rational drug use