上海市某三甲医院2015-2019年铜绿假单胞菌的分布和耐药性分析  

Distribution and drug resistance of Pseudomonas aeruginosa in a tertiary first-class hospital from 2015 to 2019 in Shanghai

作　　者：井杰 马炜[1] 刘云 谢俊豪 刘海东[1] 黄晓春[1] 秦琴[1] 刘善荣[1] JING Jie;MA Wei;LIU Yun;XIE Jun-hao;LIU Hai-dong;HUANG Xiao-chun;QIN Qin;LIU Shan-rong(Department of Laboratory Medicine,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China;Department of Endocrinology,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)长海医院实验诊断科,上海200433 [2]海军军医大学(第二军医大学)长海医院内分泌科,上海200433

出　　处：《第二军医大学学报》2020年第12期1363-1368,共6页Academic Journal of Second Military Medical University

摘　　要：目的分析我院近5年铜绿假单胞菌(PA)的临床分布及其对抗菌药物的耐药性,为临床合理使用抗菌药物和减少耐药菌株及防控院内感染提供依据。方法回顾性分析我院2015-2019年住院患者临床样本分离的PA数据,统计分析PA和耐碳青霉烯类铜绿假单胞菌(CRPA)的科室分布、样本来源及耐药率。结果2015-2019年我院1571名住院患者共分离出PA 1822株,其中CRPA 550株(30.2%)。PA及CRPA分离最多的临床科室均为烧伤科[分别占16.1%(293/1822)和17.8%(98/550)],其次是急诊科[13.9%(254/1822)和14.7%(81/550)];PA和CRPA的样本类型主要为痰/支气管肺泡灌洗液[50.3%(916/1822)和61.8%(340/550)],其次是创面分泌物[16.5%(300/1822)和10.5%(58/550)]。PA和CRPA对亚胺培南的耐药率最高[23.4%(427/1822)和93.1%(512/550)],美罗培南次之[21.2%(387/1822)和83.8%(461/550)]。结论我院PA和CRPA的分离率较高,应及时了解和分析PA和CRPA的临床分布及耐药率变化,加强耐药性监测,优化临床用药,有效预防和控制院内感染。Objective To analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa(PA)in our hospital in recent 5 years,so as to provide basis for rational use of antibiotics,reduction of drug-resistant strains and prevention and control of nosocomial infections.Methods The PA data of inpatients in our hospital from 2015 to 2019 were retrospectively analyzed.The clinical distribution,sample sources and drug resistance rate of PA and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were statistically analyzed.Results A total of 1822 PA strains were isolated from 1571 inpatients in our hospital,including 550 CRPA strains(30.2%).The department with the highest isolation rate of PA and CRPA was the Burn Department(16.1%[293/1822]and 17.8%[98/550]),followed by the Emergency Department(13.9%[254/1822]and 14.7%[81/550]).The main types of PA and CRPA samples were sputum/bronchoalveolar lavage fluid(50.3%[916/1822]and 61.8%[340/550]),followed by wound secretion(16.5%[300/1822]and 10.5%[58/550]).The resistance rates of PA and CRPA to imipenem were the highest(23.4%[427/1822]and 93.1%[512/550]),followed by meropenem(21.2%[387/1822]and 83.8%[461/550]).Conclusion The isolation rates of PA and CRPA in our hospital is high.It is necessary to timely analyze the changes of clinical distribution and drug resistance rates of PA and CRPA,strengthen drug resistance monitoring,optimize rational clinical use of drugs and effectively prevent and control nosocomial infections.

关 键 词：铜绿假单胞菌 耐碳青霉烯类铜绿假单胞菌 临床分布 细菌耐药性 

分 类 号：R446.51[医药卫生—诊断学]