临床分离铜绿假单胞菌10662株的分布及耐药性变迁  

Changing distribution and antibiotic resistance profile in 10 662 clinical strains of Pseudomonas aeruginosa

作　　者：郭小兵[1] 贺小红[1] 曹在秋 胡晓欣[1] 李远[1] 田富云[1] 任益慧 

机构地区：[1]郑州大学第一附属医院检验科,郑州450052

出　　处：《中国感染与化疗杂志》2016年第5期627-630,共4页Chinese Journal of Infection and Chemotherapy

基　　金：河南省医学科技攻关计划普通项目(201403044)

摘　　要：目的了解郑州大学第一附属医院近6年来临床分离铜绿假单胞菌对常用抗菌药物的耐药性变迁。方法收集2009年1月—2014年12月该院细菌室分离的不重复铜绿假单胞菌10 662株,分析探讨其分离率与分布、耐药性变迁、多重耐药铜绿假单胞菌检出情况。结果 2009-2014年逐年铜绿假单胞菌总分离率分别为13.8%、17.6%、15.2%、15.7%、14.4%和12.6%;主要分布在ICU(46.0%)、呼吸科(21.0%)、普外科(15.0%)和内科(11.0%)等;主要标本来源为痰液(74.7%)、血液(5.9%)、分泌物(5.7%)等;6年间铜绿假单胞菌对哌拉西林-他唑巴坦、头孢哌酮-舒巴坦、头孢他啶、美罗培南、亚胺培南耐药率呈现整体上升趋势;逐年多重耐药菌株检出率分别为22.5%、22.6%、26.0%、30.9%、32.5%和33.0%,呈升高趋势。结论该院临床分离铜绿假单胞菌对抗菌药物的耐药率处于较高水平且增长较快,应加强监测以利于临床合理应用抗菌药物。Objective To investigate the changing distribution and antibiotic resistance profile ofPseudomonas aeruginosa isolates in the past 6 years in a hospital. Methods A total of 10 662 nonduplicate P aeruginosa strains were collected from January 2009 to December 2014 in the First Affiliated Hospital of Zhengzhou University. Retrospective analysis was used to investigate the prevalence, distribution, changing antibiotic resistance profile, and prevalence of multi-drug resistant strains. Results The prevalence of P aeruginosa was at high level. The overall prevalence was 13.8% in 2009, 17.6% in 2010, 15.2% in 2011, 15.7% in 2012, 14.4% in 2013, and 12.6% in 2014. These strains were mainly distributed in ICU （46.0%）, Department of Respiratory Diseases （21.0%）, Department of General Surgery （15.0%） and Department of Internal Medicine （11.0%）. The primary source of these isolates included sputum （74.7 %）, blood （5.9 %） and secretions （5.7 %）. The P. aeruginosa strains showed a trend of increasing resistance rate to piperacillin-tazobactam, cefoperazone-sulbactam, ceftazidime, meropenem and imipenem in the 6-year period. The prevalence of multi-drug resistant strains was 22.5% in 2009, 22.6% in 2010, 26.0% in 2011, 30.9% in 2012, 32.5% in 2013 and 33.0% in 2014, respectively. Conclusions The P aeruginosa isolates in our hospital has relatively high and increasing resistance rate to the commonly used antimicrobial agents. We should strengthen the monitoring of antimicrobial resistance to ensure rational use of antimicrobial agents.

关 键 词：铜绿假单胞菌 分布 耐药性 oprD突变 

分 类 号：R446.5[医药卫生—诊断学]