铜绿假单胞菌和鲍曼不动杆菌的临床分布和耐药性分析  

Clinical distribution and drug resistance analysis of pseudomonas aeruginosa and acinetobacter baumanmii

作　　者：王亚华[1] 祝永明[2] 吴晓燕[3] 宋秀兰[4] 李旭梅[2] 陈松劲[3] 冯雪君[3] 邵平扬[3] 

机构地区：[1]浙江省嘉兴市第一医院药剂科,浙江嘉兴314001 [2]浙江省嘉兴市第二医院药剂科,浙江嘉兴314000 [3]浙江省嘉兴市第二医院检验科,浙江嘉兴314000 [4]浙江省嘉兴市第一医院检验科,浙江嘉兴314001

出　　处：《中国医药导报》2015年第16期20-23,37,共5页China Medical Herald

基　　金：浙江省重点科技创新团队基金项目(2010R50019)

摘　　要：目的调查分析医院2012～2013年铜绿假单胞菌和鲍曼不动杆菌的临床分布及耐药性，为临床合理使用抗菌药物和及早预防和控制医院感染提供科学依据。方法回顾性统计2012年1月～2013年12月嘉兴地区两所综合性三甲医院中分离的铜绿假单胞菌和鲍曼不动杆菌的临床资料，进行耐药性分析。结果铜绿假单胞菌和鲍曼不动杆菌分离率以痰液最高，分别占68．35％和81．79％；科室分布铜绿假单胞菌以呼吸内科为主（17．65％），鲍曼不动杆菌以ICU为主（19．03％）；铜绿假单胞菌对亚胺培南和美洛培南的耐药率呈逐年上升趋势，分别从8．45％、8．09％上升到13．10％、11．16％；鲍曼不动杆菌对头孢吡肟、亚胺培南、美洛培南、头孢哌酮衔巴坦、左氧氟沙星等抗菌药物耐药率为19．36％～32．80％，对氨曲南、头孢曲松的耐药率达90％。结论铜绿假单胞菌和鲍曼不动杆菌是医院最常见的条件致病菌，临床应加强耐药性监测，减少多重耐药菌的产生，避免院内感染和暴发流行。Objective To investigate the clinical distribution and drug resistance of pseudomonas aeruginosa and acinetobacter baumanmii in hospital during 2012-2013, and provide scientific basis for rational use of antibiotics in clinic and early prevention-control of hospital infections. Methods Retrospective statistics were performed for the clinical data of pseudomonas aeruginosa and acinetobacter baumannii detached from two comprehensive three-grade hospi- tals during January 2012 to December 2013 in Jiaxing, then drug resistance was analyzed. Results The detach rates of pseudomonas aeruginosa and acinetobacter baumannii were the highest in sputum, was 68.35% and 81.79% separately. Pseudomonas aeruginosa was mainly distributed in respiration medicine （17.65%）, and acinetobacter baumannii was mainly distributed in ICU （19.03%）. The resistant rate of pseudomonas aeruginosa to Imipenem increased from 8.45% to 13.10% year by year, and the resistant rate of pseudomonas aeruginosa to Meropenem increased from g.09% to 11.16%. The drug resistance rate of acinetobacter baumanmii to Cefepime, Imipenem, Meropenem, Cefoperazone/Sulbactam and Levofloxacin ranged from 19.36% to 32.80%, and the drug resistance rate of＇acinetobacter baumanmii to Aztreonam and Ceftriaxon reached 90%. Conclusion Pseudomonas aeruginosa and Acinetobaeter baumannii are the most common opportunistic pathogen in hospital. Drug resistance surveillance should be strengthened, so as to reduce the generate of multiple resistant bacteria, avoid the hospital infection and fulminant epidemic.

关 键 词：铜绿假单胞菌 鲍曼不动杆菌 抗菌药物 耐药性 

分 类 号：R378.9[医药卫生—病原生物学]