铜绿假单胞菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of 609 strains of Pseudomonas aeruginosa

作　　者：莫善颖[1] 李梦薇[1] 韦柳华[1] 黄志卓[1] 彭华[1] 蒋利君[1] 刘立民[1] 

机构地区：[1]广西医科大学第四附属医院检验科,广西柳州545005

出　　处：《中华医院感染学杂志》2013年第22期5553-5555,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区科学技术厅基金资助项目(桂科攻1140003A-43);广西壮族自治区卫生厅基金资助项目(Z2011497)

摘　　要：目的了解铜绿假单胞菌的临床分布及耐药性,为临床合理用药提供依据。方法细菌鉴定采用美国Microscan Autoscan-4微生物分析仪,药敏方法采用K-B法和微量肉汤稀释法(MIC法),应用WHONET5.4软件对结果进行统计分析,用SPSS 13.0软件进行χ2检验。结果 2010年1月-2012年6月医院住院患者共分离出铜绿假单胞菌609株,主要来源于呼吸道标本,占69.1%,其次为分泌物占23.1%;科室分布以神经外科和ICU为主,分别占22.0%和17.2%;耐碳青霉烯类铜绿假单胞菌分离率为8.5%,泛耐药铜绿假单胞菌分离率为0.3%;碳青霉烯类敏感组与碳青霉烯类耐药组药敏结果比较,哌拉西林、哌拉西林/他唑巴坦、头孢他啶、头孢噻肟、头孢吡肟、氨曲南、环丙沙星、左氧氟沙星、亚胺培南的耐药率差异有统计学意义(P<0.05),阿米卡星、庆大霉素、妥布霉素的耐药率差异无统计学意义。结论耐碳青霉烯类铜绿假单胞菌比碳青霉烯敏感铜绿假单胞菌耐药严重,密切关注耐碳青霉烯铜绿假单胞菌耐药性发展,采取有效的感染控制措施,合理使用抗菌药物,以更好地控制感染。OBJECTIVE To understand the clinical distribution and drug resistance of the clinical isolates of Pseudomonas aeruginosa so as to guide the reasonable clinical use of antibiotics. METHODS The bacterial identification was performed by using Microscan Autoscan-4 microbial analyzer of America, the drug susceptibility testing was carried out with the use of K-B method and the broth microdilution method （MIC method）, the statistical analysis was performed by using WHONET5.4 software, and the chi-square test was conducted with the use of the SPSS 13.0 software. RESULTS A total of 609 strains of P. aeruginosa were isolated from the hospitalized patients between Jan 2010 and Jun 2012, among which 69.1% were isolated from the respiratory tract specimens, 23.1% from the secretions; among the clinical departments where the strains were isolated, 22.0M were from the neurosurgery department, 17. 2% from the ICU. The isolation rate of the carbapenem-resistant P. aeruginosa was 5.8%, and the isolation rate of pandrug-resistant P. aeruginosa was 0.3%. As compared with the result of drug susceptibility testing between the carbapenem-sensitive strains and the carbapenem-resistant strains, the difference in the drug resistance rate to piperacillin, piperacillin-tazobactam, ceftazidime, cefotaxime, cefepime, aztreonam, ciprofloxacin, levofloxacin, or imipenem was significant （P〈0.05）, while the difference in the drug resistance rate to amikacin, gentamicin, or tobramycin was not significant. CONCLUSION The carbapenem-resistant P. aeruginosa strains are more drug-resistant than the carbapenem-sensitive P. aeruginosa strains. It is necessary to pay close attention to the growth of drug resistance of the carbapenem-resistant strains, take effective measures to control the infections, and reasonably use antibiotics so as to control the infections more effectively.

关 键 词：铜绿假单胞菌 碳青霉烯类 耐药性 

分 类 号：R378.991[医药卫生—病原生物学]