1001株铜绿假单胞菌临床分布及其耐药性分析  

Clinical Distribution and Drug Resistance of 1001 Strains of Pseudomonas Aeruginsa

作　　者：周剑辉[1] 李文华[1] 朱颖娴[1] 周文英[1] ZHOU Jianhui;LI Wenhua;Zhu Yingxian;ZHOU Wenying(The Fifth Affiliated Hospital,Sun-Yat-sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院,广东珠海519000

出　　处：《现代医院》2018年第11期1694-1696,1699,共4页Modern Hospitals

摘　　要：目的分析近3年来铜绿假单胞菌(PA)的临床分布及其耐药情况,为临床合理用药提供参考。方法回顾分析中山大学附属第五医院2013年1月—2015年12月3年间临床分离的1 001株铜绿假单胞菌临床分布及其耐药情况,运用WHONET 5. 6软件进行统计分析。结果 3年间分离的铜绿假单胞菌分别为235、345和421株,占同年病原菌分离率的17. 5%、18. 8%和20. 10%。该细菌分离率呈现上升趋势; 1 001株铜绿假单胞菌主要分布在痰标本、尿液中;分别占61. 5%、21. 0%。在15种常规测试的抗菌药物中,该菌对IMP的耐药率为14. 9%、23. 2%和31. 2%,其次是SCF(23. 4%、33. 6%、46. 4%)、CIP(26. 4%、34. 5%、47. 4%)和TZP(34. 5%、38. 6%、39. 3%),对其余11种抗菌药物耐药率维持在一个较高的水平,耐药率在45%～75%之间。结论铜绿假单胞菌是导致医院感染的主要病原菌之一,该菌对碳青霉烯类抗生素亚胺培南的耐药率正呈线性增加,可见我国临床铜绿假单胞菌对碳青霉烯类抗生素的耐药形势是相当严峻的。所以,临床应加强医院感染管理,加强有关科室的消毒隔离制度,严格手卫生,有效降低PAE的感染率。还应建立抗菌药物管理长效机制,加强细菌耐药监测,以提升抗菌药物合理化使用水平、提高抗菌药物对细菌的敏感性,指导临床合理用药,避免或减少耐药菌株的产生。Objective To analyze the clinical distribution and drug resistance of pseudomonas aeruginosa （PA） and provide evidence for clinical rational use of antimicrobial agents. Methods A retrospective analysis of clinical distribution and antibiotic resistance of 1,001 strains of PA was made in the fifth affiliated hospital of Sun Yat-sen University from 2013 to 2015 via Whonet 5.6 software. Results From January 2013 to December 2015, the number of PA separated were 235, 345 and 421 respectively. Correspondingly, the isolation rate of pathogenic bacterium each year was 17.5%, 18.8% and 20.10%, which displayed an upward trend. 1,001 strains of PA were mainly distributed in sputum and urine, accounting for 61.5% and 21.0% respectively. Among 15 antimicrobial agents, the antibiotic resistance of the bacterium to IMP was 14.9%, 23.2% and 31.2%, followed by SCF （23.4%, 33.6%, 46.4%）, CIP （26.4%, 34.5%, 47.4%）, TZP （34.5%, 38.6%, 39.3%） and the remaining 11 antimicrobial agents maintained at a high level between 45.0% and 75.0%. Conclusion PA is one of the main pathogen bacteria causing infection and its drug resistance of IMP is growing linearly. The situation of drug resistance is so severe that hospitals should both reduce PAE infection rate by strengthening the management of infection, disinfection and isolation system of departments and hand hygiene and avoid or reduce production of drug-resistant strains by establishing a long-term mechanism for antimicrobial drug administration, enhancing the monitoring of bacterial resistance to promote the rationalization of antimicrobial use and increase the susceptibility of antimicrobial agents to bacteria and directing rational drug use in the clinic.

关 键 词：铜绿假单胞菌 抗菌药物 耐药性 

分 类 号：R378.991[医药卫生—病原生物学]