院内下呼吸道铜绿假单胞菌感染耐药性及抗菌药物应用分析  

Drug Resistance and Antibacterial Agents use of Nosocomial Lower Respiratory Tract Infection caused by Pseudomonas Aeruginosa

作　　者：廖容花 张艳娟 杨国荣 LIAO Ronghua;ZHANG Yanjuan;YANG Guorong(Shenzhen Hangseng Hospital,Shenzhen,Guangdong 518102,China)

机构地区：[1]深圳恒生医院,广东深圳518102

出　　处：《今日药学》2018年第12期839-841,850,共4页Pharmacy Today

摘　　要：目的了解院内下呼吸道感染铜绿假单胞菌患者中的耐药性及抗菌药物的应用情况,为临床合理选用抗菌药物提供参考。方法将2017年5月～2018年5月住院治疗的下呼吸道感染患者345例作为研究对象,对患者的痰标本进行培养、分离并做药敏试验,临床药师对130株铜绿假单胞菌监测阳性的病例进行用药干预、分析病原菌耐药性及抗菌药物的使用情况。结果 345例住院患者共检出130株铜绿假单胞菌,其中检出较多的3个科室为康复医学科、脑外科及重症监护室。在耐药性检测中铜绿假单胞菌耐药率在50%以上的抗菌药物依次为氨苄西林/舒巴坦、复方新诺明、头孢曲松、替卡西林/克拉维酸、替卡西林、亚胺培南、美罗培南;铜绿假单胞菌耐药率在50%的抗菌药物为哌拉西林。院内下呼吸道感染患者治疗后,药谱组有效率(91.33%)明显高于经验组(75.00%),且差异有统计学意义(P<0.05)。结论院内下呼吸道铜绿假单胞菌感染检查中发现耐药率均较高,多重耐药较严重,在临床用药过程中应适当参考耐药检测结果进行指导用药。OBJECTIVE To understand the drug resistance and clinical application of antibiotics in patients with lower respiratory tract infection due to pseudomonas aeruginosa, so as to provide reference for clinically rational use of antibacterial agents. METHODS A total of 345 inpatients with lower respiratory tract infections from May 2017 to May 2018 were selected. The patients' sputum specimens were cultured, isolated and given drug susceptibility test. The clinical pharmacists conducted drug interventions for 130 cases of positive pseudomonas aeruginosa cases, drug resistance and application of antibiotics were analyzed. RESULTS There were 130 strains of pseudomonas aeruginosa in the detected specimens of 345 inpatients with lower respiratory tract infections, and the major detection of top three departments were 54 strains (41.54%) in department of rehabilitation medicine, 38 strains (29.23%) in department of cerebral surgery and 19 stains (14.62%) in intensive care unit. The antibacterial agents with pseudomonas aeruginosa resistance above 50% were ampicillin/sulbactam (99.23%), compound sulfamethoxazole (97.69%), ceftriaxone (74.61%), ticarcillin/clavulanic acid (55.38%), ticarcillin (55.38%), imipenem (51.38%), meropenem (50.77%) and piperacillin (50%). After treatment for patients with nosocomial lower respiratory tract infections, the effective rate in drug spectrum group was significantly higher than that in experience group (91.33% vs 75.00%) (P<0.05). CONCLUSION Through examination of nosocomial lower respiratory tract infection caused by pseudomonas aeruginosa, we found that the resistance rate is high and multidrug resistance is serious. In clinical practice, it is proper to use antibacterial agents according to the drug resistance test results.

关 键 词：下呼吸道感染 铜绿假单胞菌 耐药性 抗菌药物 

分 类 号：R969.3[医药卫生—药理学]