呼吸科重症监护室患者下呼吸道铜绿假单胞菌感染情况及耐药性分析  

The study of infection situation and antibacterial resistence of Pseudomonas aeruginosa in patients with lower respiratory tract infection in respiratory intensive care unit

作　　者：李影[1] 任皓[1] 唐爱国[1] 

机构地区：[1]中南大学湘雅二医院检验科,湖南长沙410011

出　　处：《国际检验医学杂志》2015年第8期1068-1069,1071,共3页International Journal of Laboratory Medicine

摘　　要：目的调查近5年来湘雅二医院呼吸内科重症监护室（RICU）患者下呼吸道铜绿假单胞菌（PA）感染情况,并分析其耐药性变化趋势,为指导临床合理选用抗菌药物提供参考依据。方法分离鉴定该院RICU患者及呼吸科普通病房患者2008年7月至2013年7月送检的痰标本病原菌,分析PA感染及耐药情况,并将2病区PA感染及耐药情况进行比较分析。结果 2008-2013年RICU送检的痰液标本共检出病原菌517株,其中PA为141株,占27.3%;分析其对该院14种常用抗菌药物的耐药情况,耐药率最高的为替卡西林/克拉维酸（61.0%）,最低的为多黏菌素B（9.2%）。普通病房同期送检痰标本检出病原菌378株,其中PA为125株,占33.1%,耐药率最高的药物为替卡西林/克拉维酸（28.0%）,最低的药物为多黏菌素B（4.0%）。结论 PA仍然是近5年该院RICU患者下呼吸道感染的主要致病菌之一,且抗菌药物耐药情况逐年上升;RICU抗菌药物耐药情况普遍高于呼吸内科普通病房。临床尤其是RICU需采取有效措施防止院内感染,合理使用抗菌药物以减少耐药株的出现。Objective To investigate the infection situation of Pseudomonas aeruginosa （PA） in patients with the lower respira‐tory tract infection in the department of respiratory intensive care units （RICU ） in recent five years ,and to analyze the changing trend of antibacterial resistence ,in order to guide rational selection of antimicrobial agents .Methods Strains of bacteria were isolated and identified from sputum specimen of patients in the department of RICU and common ward from Jul .2008 to Jul .2013 .The situations of PA infection and antibacterial resistence were analyzed ,and differences of infection rates of PA and antibacterial resis‐tence were compared between RICU and common ward .Results 517 strains of bacteria were detected from sputum specimens of patients in the department of RICU from 2008 to 2013 ,including 141 strains of PA （accounted for 27 .3% ） ,and ticarcilli/clavulanic acid（61 .0% ） was with the highest rate of resistance among 14 drugs and colistin B（9 .2% ） was with the lowest rate of resistance . 378 strains of bacterias were detected from sputum specimens of patients in common wards ,including 125 strians of PA（accounted for 33 .1% ） ,and ticarcilli/clavulanic acid（28 .0% ） was with the highest rates of resistance and colistin B （4 .0% ） was with the low‐est rate of resistance .Conclusion In recent 5 years ,PA might be one of the main pathogenic bacterias of respiratory tract infections in the depatment of RICU in this hospital ,and antibiotic resistance may increse gradually .The antibiotic resistance in the depatment of RICU may be higher than that in cionmon wards .Clinical effective measures should be taken to prevent nosocomial infection ,and rational use of antibiotics should be taken to reduce the emergence of resistant strains .

关 键 词：铜绿假单胞菌 呼吸科重症监护室 耐药性 感染 

分 类 号：R446.5[医药卫生—诊断学]