豫北地区铜绿假单胞菌感染分布和耐药性的分析  

Distribution of Pseudomonas aeruginosa infections and analysis of drug resistance in northern Henan

作　　者：张海涛[1] 胡东洋[1] 杜纪英[1] 梁梦夏 娄婷叶[2] 王明永[3] 

机构地区：[1]新乡医学院三全学院检验与影像学院,河南新乡453000 [2]新乡医学院第一附属医院检验科,河南新乡453100 [3]新乡医学院医学检验学院,河南新乡453003

出　　处：《海南医学》2015年第21期3167-3169,共3页Hainan Medical Journal

基　　金：教育部新世纪优秀人才支持计划(编号:NCET-13-0990);河南省高校科技创新人才项目(编号:2012HASTIT024);河南省高校青年教师骨干项目(编号:2010GGJS-117);新乡医学院三全学院大学生科研项目(编号:201412002ZZ)

摘　　要：目的了解铜绿假单胞菌（PA）感染分布及其耐药情况，指导lI缶床医生合理使用抗生素，有效预防及控制院内感染。方法应用美国DadeMicmScall公司生产的AutoSCAN4半自动鉴定仪及配套的生化反应药敏板进行鉴定。参照2014版CLSI标准进行药敏结果判读。结果2014—2015年间共收集534株多重耐药铜绿假单胞菌菌株，其中男性感染者占71.35％（381／534），且年龄分布在60～69岁者最多。标本类型主要是痰液（413份，77.34％），其次为分泌物（47份，8.80％）和中段尿（24份，4.49％）。分离的铜绿假单胞菌主要分布在神经外科18.54％（99／534）、呼吸科16.10％（86／534）和重症监护室12.92％（69／534）三个科室。铜绿假单胞菌对16种抗生素的药敏试验显示耐药率较低的药物有阿米卡星（21.72％）、哌拉西林，他唑巴坦（26.78％），而头孢唑林、氨苄西林／舒巴坦则耐药率较高，均为99.63％。结论铜绿假单胞菌对抗菌药物存在多重耐药性且耐药率高，临床医生应根据其临床分布特点和药敏试验结果合理选择抗菌药物。Objective To investigate the distribution ofPseudomonas aeruginosa （PA） infection and the drug resistance situation, guide the reasonable use of antibiotics in clinic, and effectively prevent and control nosocomial in- fection. Methods Semi-automatic identification system Auto SCAN4 （American Dada MicmScall company） and the matching biochemical drug susceptibility plate were used for the identification of PA infection, and the CLSI standard the （2014 edition） was used for interpreting the drug sensitivity resu!ts. Results During the period of 2014 to 2015, a total of 534 strains of multi-resistant Pseudornonas aeruginosa were collected, including 381 strains from male patients （71.35%, 381/534）, whose age mainly distributed in the range of 60-69. The main type of specimens was sputum （413 specimens, 77.34%）, followed by secretion （47 specimens, 8.80%） and urine （24 specimens, 4.49%）. Pseudomonas ae- ruginosa mostly distributed in the Department of Neurosurgery （18.54%, 99/534）, the Department of Respiration （16.10%, 86/534） and Intensive Care Unit （12.92%, 69/534）. Drug sensitivity test of Pseudomonoz aeruginosa to 16 kinds of antibiotics showed low drug resistance rate in Amikaein （21.89%）, Piperacillin/Tazobactam （26.93%）, and high drug resistance rate in Cefazolin, Arnpicillin/sulbactam （up to 99.81%）. Conclusion Pseudomonas aeruginosa shows multi-resistance to antibiotics, and the drug resistance is high. Clinicians should choose antimicrobial agents reasonably according to the characteristics of clinical distribution and drug susceptibility test results.

关 键 词：铜绿假单胞菌 耐药性 医院感染 豫北地区 

分 类 号：R378.991[医药卫生—病原生物学]