中国西部地区耐亚胺培南铜绿假单胞菌的分布及耐药特点  

Drug resistance and distribution characteristics of imipenem-resistant Pseudomonas aeruginosa in Western China

作　　者：幸运 鲁卫平 喻华[2] 张华[3] 季萍[4] 单斌[5] 阿祥仁[6] 贾伟[7] 郭素芳[8] 魏莲花[9] 徐修礼 Xing Yun;Lu Wei-ping;Yu Hua;Zhang Hua;Ji Ping;Shan Bin;A Xiang-ren;Jia Wei;Guo Su-fang;Wei Lian-hua(The Third Affiliated Hospital of the Army Medical University,Chongqing 400042;Sichuan Academy of Medical Sciences,Sichuan Provincial People＇s Hospital,Chengdu 610072;Guizhou Provincial People＇s Hospital,Guiyang 550001;The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054;First Affiliated Hospital of Kunming Medical University,Kunming 650032;Qinghai Provincial People＇s Hospital,Xining 810007;General Hospital of Ningxia University,Yinchuan 750004;Department of Clinical Laboratory,Affiliated Hospital of Inner Mongolia Medicine University,Huhhot 010050;Department of Clinical Laboratory,Gansu Provincial Hospital,Lanzhou 730000;Research Institute of Clinical Laboratory Medicine of PLA,Xijing Hospital,Xi＇an 710032)

机构地区：[1]陆军军医大学第三附属医院(野战外科研究所)检验科,重庆400042 [2]四川省医学科学院.四川省人民医院,成都610072 [3]贵州省人民医院,贵州550001 [4]新疆医科大学一附院医学检验中心,乌鲁木齐830054 [5]昆明医科大学第一附属医院,昆明650032 [6]青海省人民医院,西宁810007 [7]宁夏医科大学总医院,银川750004 [8]内蒙古医科大学附属医院检验科,呼和浩特010050 [9]甘肃省人民医院检验中心,兰州730000 [10]空军军医大学西京医院全军临床检验医学研究所,西安710032

出　　处：《中国抗生素杂志》2018年第9期1079-1082,共4页Chinese Journal of Antibiotics

摘　　要：目的探讨中国西部地区耐亚胺培南铜绿假单胞菌的分布及耐药特点,为预防和控制医院感染,合理使用抗菌药物提供依据。方法回顾性分析2016—2017年,中国西部地区10家三甲医院微生物实验室从临床标本中分离到的耐亚胺培南铜绿假单胞菌分布及耐药性特点;数据统计及药敏分析采用WHONET 5.6软件。结果 2016—2017年共分离到铜绿假胞菌7676株,其中耐亚胺培南铜绿假单胞菌1463株(19.1%)。耐亚胺培南铜绿假单胞菌主要分离自痰液标本,2016年和2017年分别占72.4%和74.8%,其次为尿液和分泌物。科室分布以重症监护室为主,2016年和2017年分别占17.6%和18.1%,其次是神经外科和呼吸科。年龄分布特征,61～70岁的患者人数最多,共303例(占20.7%),10岁及以下的患者人数最少,共36例(占2.5%)。耐药分析结果显示,中国西部地区耐亚胺培南铜绿假单胞菌对阿米卡星耐药率较低,2016年和2017年分别为16.3%和25.7%,对左氧氟沙星耐药率较高,分别为43.4%和45.5%;对临床常用的抗菌药物的耐药性,2017年均高于2016年。结论中国西部地区耐亚胺培南铜绿假单胞菌主要分离自痰液标本,61～70岁的中老龄患者分离率较高,目前耐药形势严峻,对临床常用抗菌药物的耐药性呈上升趋势,医院应加强抗菌药物的管理和对耐亚胺培南铜绿假单胞菌感染病例的实时监控,减少此类耐药菌在医院内传播。Objective To study the resistance and distribution of imipenem-resistant Pseudomonas aeruginosa in Western China. Methods A retrospective survey and statistics were carried out on 1459 strains of imipenem -resistant Pseudomonas aeruginosa infections and drug resistance rates from 2016 to 2017, and the WHONET 5.6 software was used to perform statistical analysis on drug susceptibility results. Results From 2016 to 2017, 7676 strains of Pseudomonas aeruginosa were isolated, of which 1,463 strains were resistant to imipenem （19.1%）. Imipenem-resistant Pseudomonas aeruginosa was mainly isolated from sputum specimens, accounting for 72.4% and 74.8% in 2016 and 2017, respectively, followed by urine and secretions. The distribution of departments was mainly intensive care units, accounting for 17.6% and 18.1% in 2016 and 2017, respectively, followed by neurosurgery and respiratory departments. As for the characteristics of the age distribution, the number of patients aged 61-70 years was the highest, with a total of 303 cases （20.7%）, which was significantly more than other age groups. The number of patients aged 10 and under was the lowest, with a total of 36 cases （2.5%）. The antimicrobial resistance of 1,463 imipenem-resistant Pseudomonas aeruginosa to 10 commonly used antimicrobial agents was counted. In 2016 and 2017, the resistance rate to amikacin was relatively low, which was 16.3% and 25.7%, respectively, followed by tobramycin, gentamicin, piperacillin/tazobactam, and ciprofioxacin. The resistance rate to levofloxacin was higher, which was 43.4% and 45.5%, respectively. Drug resistance rates to commonly used antibiotics in 2018 were higher than those in 2016. Conclusion Imipenem-resistant Pseudomonas aeruginosa was more common in sputum, and the isolation rates of the middle-aged and older patients aged 61-70 years were high. The current situation of drug resistance is severe. Clinical use should be rationally administered under the guidance of antibiotic susceptibility results. Hospitals should st

关 键 词：中国西部 亚胺培南耐药 铜绿假单胞菌 耐药性 

分 类 号：R978.1[医药卫生—药品]