2011-2015年开放伤口感染铜绿假单胞菌耐药性变迁研究  

Change of drug resistance of Pseudomonas aeruginosa causing open wound infection from 2011to 2015

作　　者：谢朝云[1,2] 闫飞[1] 熊永发[1] 熊芸[2] 杨忠玲 杨怀[4] 

机构地区：[1]贵州医科大学第三附属医院骨科,贵州都匀558000 [2]贵州医科大学第三附属医院感染管理科,贵州都匀558000 [3]贵州医科大学第三附属医院检验科,贵州都匀558000 [4]贵州省人民医院感染管理科,贵州贵阳550002

出　　处：《中华医院感染学杂志》2016年第11期2441-2443,共3页Chinese Journal of Nosocomiology

基　　金：贵州省科技厅联合基金资助项目(黔科合LH字[2014]7162);贵州省黔南州社会发展科技基金资助项目(黔南科合社字[2013]20)

摘　　要：目的了解开放伤口感染标本中分离的铜绿假单胞菌耐药性变迁,为临床合理使用抗菌药物提供依据。方法收集2011-2015年医院收治创伤患者开放伤口的分泌物,病原学鉴定采用VITEK-2全自动微生物鉴定系统,药敏试验采用K-B纸片扩散法,按照美国临床和实验室标准化研究所标准判断,数据用WHONET5.6及SPSS20.0统计软件进行分析。结果 2011-2015年创伤患者开放伤口标本中铜绿假单胞菌检出率分别为11.81%、11.46%、13.11%、13.75%、14.13%;创伤患者铜绿假单胞菌感染科室以骨科、普外科和烧伤整形科检出较多,依次为骨科、普外科、烧伤整形科、ICU及脊柱科,分别占42.03%、19.81%、14.98%、7.25%及5.31%;铜绿假单胞菌对阿米卡星、哌拉西林/他唑巴坦和亚胺培南耐药性较低,分别为11.76%、17.65%、13.73%,对大部分抗菌药物耐药性均呈上升趋势。结论创伤患者开放伤口铜绿假单胞菌感染率与耐药性显上升趋势,临床应做好彻底清创止血,严格无菌操作观念,合理选用抗菌药物,对环境及设备严格消毒隔离措施,提高手卫生依从性,减少耐药菌株扩散。OBJECTIVE To understand the change of drug resistance of Pseudomonas aeruginosa strains isolated from specimens of patients with open wound infection so as to provide guidance for reasonable clinical use of antibiotics.METHODS The open wound sections specimens were collected from the wound patients who were treated in the hospitals from 2011 to 2015,the etiological identification was carried out by using VITEK-2automatic microorganism identification system,the drug susceptibility testing was conducted by means of K-B disk diffusion method,the results were interpreted on the basis of the criteria of CLSI,and the statistical analysis of data was performed with the use of WHONET5.6software and SPSS20.0software.RESULTS The isolation rate of the P.aeruginosa in the open wound specimens was 11.81% in 2011,11.46% in 2012,13.11% in 2013,13.75% in2014,14.13%in 2015.Of the wound patients with P.aeruginosainfection,42.03% distributed in the department of orthopedics,19.81%in the department of general surgery,14.98%in the department of burns and plastic surgery,7.25%in ICU,5.31%in the department of spine.The drug resistance rates of the P.aeruginosato amikacin,piperacillin-tazobactam,and imipenem were 11.76%,17.65%,and 13.73%,respectively;the drug resistance rates to most of the antibiotics showed upward trends.CONCLUSIONThe incidence of the P.aeruginosa infection in the wound patients and the drug resistance rates are remarkably increased.It is necessary for the hospital to conduct thorough debridement,conform to the strict idea of aseptic operation,reasonably use antibiotics,take rigid disinfection and isolation measures for environment and equipments,and improve the hand hygiene compliance so as to prevent the spread of drug-resistant strains.

关 键 词：创伤患者 开放伤口 铜绿假单胞菌 耐药性 变迁 

分 类 号：R378.991[医药卫生—病原生物学]