医院铜绿假单胞菌的感染分布现状和耐药变迁  

The distribution and the resistance change of Pseudomonas aerations infected in hospital

作　　者：赖桂桦 张红梅[2] 韩翔[1] 王丽娜[3] 赵常青[3] 周珍珍[3] 

机构地区：[1]石河子大学医学院医学检验系,新疆石河子832002 [2]石河子大学医学院第一附属医院检验科,新疆石河子832008 [3]石河子大学医学院临床医学系,新疆石河子832002

出　　处：《农垦医学》2015年第5期455-458,共4页Journal of Nongken Medicine

基　　金：石河子大学第十二期大学生研究训练计划项目(SRP2014229)

摘　　要：目的：了解铜绿假单胞菌在我院的临床感染分布特点及对抗菌药耐药性的变化趋势,为指导临床用药,控制感染提供理论依据。方法：对2012年1月至2014年12月住院患者送检各类标本进行分离培养,采用全自动微生物鉴定仪VITEK 2 Compact为934株铜绿假单胞菌进行鉴定和药敏试验。结果：934株铜绿假单胞菌中,来自痰液标本577株,占了61.78%,分泌物197株占了21.09%,其他标本160株占了17.13%。铜绿假单胞菌对氨苄西林/舒巴坦、头孢曲松、复方新诺明的耐药率高达97.64%、97.32%、96.69%;阿米卡星、妥布霉素、庆大霉素、美洛培南的耐药率较低分别为4.60%、6.00%、7.49%、9.10%;2014年铜绿假单胞菌对氨苄西林/舒巴坦、头孢曲松、复方新诺明的耐药率与2012年和2013年相比均下降;2014年铜绿假单胞菌对妥布霉素、庆大霉素、环丙沙星的耐药率有所上升;阿米卡星的耐药率呈现下降趋势。结论：临床检测出的铜绿假单胞菌中,大部分来源于痰标本;2012~2014年三年间,铜绿假单胞菌的耐药率总体变化不大,对各种抗菌药物的耐药率偏高。因此医院要提高送检率,做好铜绿假单胞菌的耐药监测工作,以指导临床合理使用抗菌药物,降低耐药率,减少治疗费用。Objective：To study the distribution characteristics of Pseudomonas aeruginosa infection in clinical and the trends of antimicrobial resistance change of our hospital.To guide clinical rational use of antimicrobial agents and provide a theoretical basis for the infection control. Methods：From 2012 January to 2014 December various samples of inpatients were isolated and cultured,using the automatic microorganism identification instrument VITEK2 Compact to test 934 strains of Pseudomonas aeruginosa susceptibility. Results：934 strains of Pseudomonas aeruginosa,577 strains were from sputum specimens accounted for 61.78%,197 strains were from secretion specimens accounted for 21.09%,other 160 strains were accounted for 17.13%.Pseudomonas aeruginosa toceftriaxone,ampicillin/Shubatan,recurrence of sulfamethoxazole resistance rates were as high as 97.64%,97.32%,96.79%;Amikacin,gentamicin,tobramycin,meropenem resistance rates were 4.60%,6.00%,7.49%,9.10%;Resistance rates of Pseudomonas aeruginosa to ceftriaxone,ampicillin /Shubatan recurrence,sulfamethoxazole in 2014 decreased as compared with 2012 and 2013;resistance rates of Pseudomonas aeruginosa to gentamicin,tobramycin,ciprofloxacin increased;the resistance rate of Amikacin show a downward trend. Conclusion：Pseudomonas aeruginosa detected in the clinical mostly resource from sputum specimens;from 2012 to 2014,the overall change of the drug resistance rate of Pseudomonas aeruginosa is not obvious,but a variety of antimicrobial drug resistance rate is high.Therefore,the hospital should improve the detection rate,drug resistance monitoring work of Pseudomonas aeruginosa,guiding clinical rational use of antimicrobial drugs,reducing the drug resistance rate,in order to reduce the cost of treatment.

关 键 词：铜绿假单胞菌 耐药性 抗菌药物 耐药性变迁 

分 类 号：R197.323.4[医药卫生—卫生事业管理]