505株临床分离的铜绿假单胞菌的临床分布与耐药性分析  

The Clinical Distribution and Drug Resistance on 505 Pseudomonas Aeruginosa Strains

作　　者：吴怡[1] 王岚[1] 刘新[1] 张翀[2] 叶梦[3] 

机构地区：[1]沈阳医学院基础医学院病原生物学教研室,辽宁沈阳110034 [2]沈阳医学院附属中心医院检验科 [3]沈阳医学院基础医学院

出　　处：《沈阳医学院学报》2014年第3期141-143,共3页Journal of Shenyang Medical College

基　　金：沈阳医学院青年基金项目(No:20132028)

摘　　要：目的:回顾分析临床分离的505株铜绿假单胞菌临床分布及药敏结果,为进一步指导临床合理使用抗生素提供依据。方法:2008年9月至2012年9月沈阳医学院附属中心医院患者送检的各类标本中通过分离培养获得铜绿假单胞菌505株,采用纸片琼脂扩散法对上述菌株进行药物敏感试验及结果分析。结果:(1)临床送检的各类标本中铜绿假单胞菌的检出率依次为:痰液(83.6%),伤口分泌物(4.5%),尿液(3.1%),脓汁(2.5%)和血液(1.4%)。(2)各科室检出率:ICU病房(30.5%),干诊病房(21.3%),呼吸内科病房(18.4%),神经外科病房(12%),神经内科病房(9.2%),普外科病房(1.4%)和手外科病房(1.3%)。(3)耐药性分析结果显示上述菌株耐药率最高的是磺胺甲唑/甲氧苄啶(72.1%),最低的是头孢哌酮/舒巴坦(16.9%),对亚胺培南和美洛培南的耐药率为20.4%和22.7%。结论:在各类送检标本中,铜绿假单胞菌的检出率以痰液标本最高,其临床分布主要集中于ICU病房。临床治疗铜绿假单胞菌感染耐药率最低的药物为头孢哌酮/舒巴坦,对碳青霉烯类抗生素亚胺培南和美洛培南耐药率有逐年增高趋势。Objective ： To provide evidences for diagnosis and treatment of clinical infection through analysis of clinical distribution and drug sensitive test on 505 strains of Pseudomonas aeruginosa. Methods： A total of 505 strains of P. aeruginosa were isolated from various specimens delivered from the Central Hospital Affiliated to Shenyang Medical College from Sep 2008 to Sep 2012. Drug sensitivity test in vitro was performed with K-B method in these strains. Results： （ 1 ） The positive rate of P. aeruginosa in various specimens were sputum （83.6%） , the wound secretion （4. 5% ） , urine （3. 1% ） , pus （2. 5% ） and blood （ 1.4% ） in order. （2） The positive rate in each department was ICU （30. 5% ）, cadre ward （21.3%）, respiratory internal medicine ward （18.4%） , neurosurgery ward （12%） , neurology ward （9. 2%） , general surgery ward （ 1.4% ） and hand surgery ward （ 1.3% ）. （3） The result analysis of drug sensitivity test on 505 strains above showed that the resistance rate to Sulfamethoxazole/ Trimethoprim was the highest （72.1%）, Cefoperazone/Sulbaetam was the lowest （16. 9% ） and lmipenem and Meropenem was 20.4% and 22. 7%, respectively. Conclusion： The positive rate of P. aernginosa in sputum specimen is the most. The strains are mostly distributed in ICU. The drug resistance rate to Cefoperazone/Sulbactam is the lowest in clinical, the drug resistance rate to Imipenem and Meropenem are increasing year by year.

关 键 词：铜绿假单胞菌 临床分布 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]