2009～2014年济南市某医院铜绿假单胞菌分布及耐药性变迁  

Distribution and Resistance Diversity of Pseudomonas aeruginosa Isolated in a hospital,Jinan City,2009-2014

作　　者：裴凤艳[1] 吴洪巧[2] 张芳[1] 

机构地区：[1]山东大学附属济南市中心医院医学实验诊断中心,山东济南250013 [2]山东大学附属济南市中心医院医院感染管理科,山东济南250013

出　　处：《预防医学论坛》2015年第8期576-578,共3页Preventive Medicine Tribune

基　　金：十二五"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项基金资助项目(2012ZX10004-206)

摘　　要：目的了解济南市某医院临床分离铜绿假单胞菌（PAE）的分布及其耐药性变迁。方法以美国临床和实验室标准协会（CLSI）2014版为标准判定药敏试验结果,使用WHONET 5.6软件分析数据。结果 2009～2014年从临床标本中共分离PAE 1 578株,分离率逐年上升,但2014年略有下降,平均为16.30%。其中,27.53%分离自呼吸内科患者,其次为急诊ICU（8.03%）和烧伤病房（5.42%）。标本来源以呼吸道为主,占83.84%。2009～2012年间PAE耐药性整体呈上升趋势,但2013～2014年亚胺培南、美罗培南、哌拉西林、哌拉西林/他唑巴坦、氨曲南、头孢吡肟、头孢他啶、头孢哌酮/舒巴坦等抗菌药物的耐药率反而下降。平均耐药率最高的是替卡西林/克拉维酸（37.92%）,超过20%的抗菌药物有亚胺培南（28.96%）、左氧氟沙星（25.80%）、氨曲南（25.08%）、美罗培南（24.23%）、哌拉西林（20.77%）。结论铜绿假单胞菌主要来自呼吸道标本,2009～2012年间其分离率和耐药率呈逐年上升趋势,但耐药率近两年呈下降趋势。Objective To understand the characteristics of distribution and the change of drug resistance of Pseudomonas aeruginosa clinical isolates collected from a hospital during the past six years. Methods Data were analyzed according to the breakpoints of CLSI 2014. The clinical data were reviewed retrospectively by software WHONET5.6. Results A total of 1 578 P, aeruginosa clinical isolates were analyzed during the six years. The isolating rate was 16.30% ,increasing year by year in addition to 2014.27.53 % of P. aeruginosa isolates came from pneumology department, followed by ICU and burn department, 8. 03% and 5.42% respectively. 83.84% of these strains were cultured from respiratory sam- ples. The antibiotics resistance rates of P. aeruginosa isolates overall kept an increasing tendency from 2009 to 2012 ,but the majority of them showed a declining trend in 2013 and 2014.37.92% of the P. aeruginosa isolates showed the highest resistance to ticarcililin-clavulanate. More than 20% of the P. aeruginosa strains were resistantto Imipenem （28.96 %）, Levofloxacin（25. 80%）, Aztreonam （25.08%）, Meropenem （24.23%）, and Piperaeillin （20. 77%） . Less than 20% the P. aeruginosa strains were resistant to otherantibiotics. Conclusion P. aeruginosa strains are isolated from respiratory samples mainly. Theisolating rate and the antibiotics resistance rates of P. aeruginosa isolates overall keep an increasing tendency from 2009 to 2012, but a declining trend in recent two years.

关 键 词：铜绿假单胞菌 耐药 抗菌药物 合理用药 

分 类 号：R378.991[医药卫生—病原生物学]