1173株铜绿假单胞菌临床分布及耐药性变迁  

Clinical Distribution and Drug Resistance of 1173 Strains of Pseudomonas aeruginosa

作　　者：郑远明[1] 毕晓英 周杰[1] Zheng Yuan-ming;Bi Xiao-ying;Zhou Jie(Affiliated Dalian Friendship Hospital of Dalian Medical University,Liaoning 116020)

机构地区：[1]大连市友谊医院,辽宁116001

出　　处：《国外医药（抗生素分册）》2018年第6期535-539,共5页World Notes on Antibiotics

摘　　要：目的了解近3年大连市友谊医院铜绿假单胞菌感染的分布情况及其耐药性变迁,为临床更加合理的使用抗生素提供依据。方法回顾性分析大连市友谊医院2015年1月—2017年12月三年住院患者中分离的1173株铜绿假单胞菌,采用MIC法和K-B纸片扩散法检测其对抗菌药物的耐药性,利用WHONET 5.6和SPSS 19.0软件进行统计分析。结果分离的1173株铜绿假单胞菌主要来源于痰液(882株,75.19%),其次为尿液(141株,12.02%);分布最广的科室为重症医学科(12.63%)和老年病区(12.33%)。三年平均耐药率最高是美罗培南(39.5%),最低阿米卡星(22.7%);哌拉西林、头孢哌酮-舒巴坦、头孢他啶、头孢吡肟、氨曲南、美罗培南、阿米卡星、妥布霉素、环丙沙星、左旋氧氟沙星10种抗菌药物的耐药率三年均有下降,其中除阿米卡星、妥布霉素和环丙沙星外其他几种抗菌药物耐药率下降的相关性显著(P<0.05),具有统计意义。结论铜绿假单胞菌是细菌感染中重要的致病菌且易产生多重耐药性,应加强对铜绿假单胞菌感染的管理,合理使用抗菌药物,减少耐药的发生。Objective To understand the distribution of Pseudomonas aeruginosa （PAE） infection in Affiliated Dalian Friendship Hospital in the past 3 years and its changes in drug resistance, and to provide evidence for more rational use of antibiotics in clinical practice. Methods 1173 strains of PAE isolated from Affiliated Dalian Friendship Hospital from January 2015 to December 2017 were analyzed. The sensitivity of antibiotics was detected by MIC method and K-B paper diffusion method, and the software of WHONET 5.6 and SPSS 19 was used for statistical analysis. Results The 1173 isolated PAE were mainly derived from sputum（882, 75.19）, followed by urine（141, 12.02%）. The most widely distributed departments were 12.63% of the intensive care departments, followed by the elderly wards, accounting for 12.33%. The average drug resistance rate of MEM was the highest in three years, up to 39.5%. The second was levofloxacin （LVX）, up to 38.3%. And the lowest average drug resistance rate was Amikacin （AMK） in three years, low to 22.7%. The drug sensitivity results showed that piperacillin （PIP）, cefoperazone - Shu Batan （CSL）, ceftazidime （CAZ）, cefepime （FEP）, amamenan （ATM）, MEM, AMK, tobramycin （TOB）, ciprofloxacin （CIP） and levofloxacin （LVX） were on the decline. The correlation among the resistance rates of PIP, CSL, CAZ, FEP, ATM, MEM, and LVX decreased significantly （P〈0.05）, which was statistically significant. Conclusion Pseudomonas aeruginosa is an important pathogenic bacteria in bacterial infection and is easy to produce multiple drug resistance. It is necessary to strengthen the management ofPseudomonas aeruginosa infection, rational use of antibiotics and reduce the occurrence of drug resistance.

关 键 词：铜绿假单胞菌 耐药性 抗菌药物 临床分布 

分 类 号：R446.5[医药卫生—诊断学]