铜绿假单胞菌感染临床分布及耐药性分析  

A clinical survey on distribution and drug resistance of Pseudomonas aeruginosa

作　　者：郝巧歆 吕治[2] 苏建荣[2] 

机构地区：[1]中国航天科工集团七三一医院检验科,北京100074 [2]首都医科大学附属北京友谊医院临床检验中心,北京100050

出　　处：《临床和实验医学杂志》2016年第20期2060-2062,共3页Journal of Clinical and Experimental Medicine

基　　金：首都临床特色应用研究项目(编号:Z141107006614005)

摘　　要：目的了解铜绿假单胞菌感染的临床分布及其耐药性特点,为临床的合理用药提供参考依据。方法收集2014年1月至2015年12月临床分离的铜绿假单胞菌,采用VITEK2Compact微生物全自动鉴定仪进行鉴定,采用K-B纸片扩散法进行药敏试验,依据美国CLSI2014版的标准进行细菌药敏结果的判读,采用WHONET5.6进行的数据处理和分析。结果两年各类标本共分离出铜绿假单胞菌203株,标本分布以痰液,尿液,分泌物为主,分别占69.9%,12.8%,8.9%;科室分布以呼吸内科和ICU为主,分别占21.2%,18.7%。接受侵袭性操作、长期住院免疫力低下的高龄患者为易感因素;铜绿假单胞菌对多粘菌素B耐药率最低;其次耐药率最低为妥布霉素,哌拉西林+他唑巴坦,庆大霉素分别为11.8%,14.3%,16.3%;而耐亚胺培南的铜绿假单胞菌为21.7%。结论该院的铜绿假单胞菌主要来自痰标本,感染的主要科室是呼吸内科和ICU;其对多粘菌素B、妥布霉素和哌拉西林+他唑巴坦耐药率最低。Objective To survey the clinical distribution and drug resistance of Pseudomonas aeruginosa caused infections in order to provide the guidance for rational application of drugs.Methods The data of clinically isolated strains of Pseudomonas aeruginosa during January2014 to December 2015 were collected and analyzed.The identification of isolates had been carried out by using VITEK2 Compact automatic identification system,and the testing of drug susceptibility was performed by K-B disc diffusion method,the results were carried out according to the Standard of CLSI 2014 version for interpretation,and the data analysis was performed with WHONET5.6.Results A total of 203 strains of Pseudomonas aeruginosa had been isolated from various specimens obtained during these two years.69.9% of them were isolated from sputum specimens,12.8% of them were isolated from urine specimens,and 8.9% of them were isolated from secretion specimens.The patients with this kind of infection in the Department of Respiratory Diseases accounted for 21.2%,and patients with this kind of infection in ICU accounted for18.7 %.Elder patients with invasive operation,long-term hospitalization and low immunity were su4 sceptible factors for this kind of infection.The rate of drug resistance of Pseudomonas aeruginosa to polymyxin B was the lowest,followed by tobramycin（ 11.8%）,piperacillin-tazobactam（ 14.3%）,gentamicin（ 16.3%）,and the drug resistance rate of Pseudomonas aeruginosa to imipenem was 21.7%.Conclusion The main source for isolation of Pseudomonas aeruginosa in this hospital mainly comes from sputum specimens of patients in ICU and Department of Respiratory Diseases.The rates of drug resistance of Pseudomonas aeruginosa to polymyxin B,tobramycin and piperacillin-tazobactam are the lowest.

关 键 词：铜绿假单胞菌 临床分布 耐药性 医院感染 

分 类 号：R446.5[医药卫生—诊断学]