2016—2018年某医院耐碳青霉烯类铜绿假单胞菌的耐药性及临床特征分析  

Analysis of drug resistance and clinical characteristics of carbapenem-resistant Pseudomonas aeruginosa from 2016 to 2018

作　　者：余建洪[1] 李敏 何小平[1] 陈喻[1] 张肃川 张小丹 YU Jianhong;LI Min;HE Xiaoping;CHEN Yu;ZHANG Suchuan;ZHANG Xiaodan(Department of Clinical Laboratory,Zigong First People’s Hospital,Zigong,Sichuan 643000,China;Department of Laboratory,Chengdu Medical College,Chengdu,Sichuan 610083,China)

机构地区：[1]自贡市第一人民医院检验科,四川自贡643000 [2]成都医学院检验系,四川成都610083

出　　处：《安徽医药》2021年第5期931-934,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的了解耐碳青霉烯类铜绿假单胞菌(CRPA)的耐药情况及临床特征,为临床治疗及医院感染防控提供依据。方法选取2016—2018年自贡市第一人民医院分离的临床菌株,采用WHONET 5.6及SPSS 19.0软件对数据进行分析。结果共分离出铜绿假单胞菌936株,其中2016—2018年分别为277、338和321株,CRPA的检出率分别为10.11%、10.65%和8.72%,CRPA的总体检出率为9.83%。科室分布以呼吸内科(31.52%)、重症医学科(13.04%)、泌尿外科(9.78%)、中西结合科(6.52%)和神经外科(6.52%)为主。标本类型中,以痰液为主,占78.26%,其次为尿液,占13.04%。年龄分布以>60~70岁(28.26%)和>50~60岁(23.91%)人群最多见。3年间,CRPA对庆大霉素的耐药率呈逐年增长趋势,差异有统计学意义(P<0.05),而对其他常见抗菌药物的耐药率呈稳定趋势,对氨基糖苷类抗菌药物耐药率较低(<20.0%),亚胺培南比美罗培南具有更高的CRPA检出灵敏度(P<0.05),其检出率分别为90.22%和69.57%。临床治疗以两种或三种抗菌药物联合应用为主(70.65%),50%以上病人接收了糖皮质激素的抗炎治疗。结论我院的CRPA以呼吸道感染为主,多见于呼吸内科和重症医学科,其感染会增加病人经济负担及病人住院时间,临床及感染防控部门应采取措施以减少其流行。Objective To investigate the drug resistance and clinical characteristics of carbapenem-resistant pseudomonas aeruginosa(CRPA),and provide a basis for clinical treatment and prevention and control of nosocomial infection.Methods The clinical strains isolated in Zigong First People’s Hospital from 2016 to 2018 were selected and the data were analyzed by WHONET 5.6 and SPSS19.0 software.Results A total of 936 strains of pseudomonas aeruginosa were isolated,of which 277,338,321 strains were isolated from 2016 to 2018,respectively.The detection rate of CRPA was 10.11%,10.65%and 8.72%,respectively.The overall detection rate of CRPA was 9.83%.The main departments were respiratory medicine(31.52%),severe medicine(13.04%),urology(8.70%),combination of Chinese and western medicine(6.52%)and neurosurgery(6.52%).The main type of specimen was sputum(78.26%),followed by urine(13.04%).The most common age distribution was>60-70 years old(28.26%)and>50-60 years old(23.91%).During the past three years,the resistance rate of CRPA to gentamicin increased year by year,the difference was statistically significant(P<0.05),but the resistance rate to other common antibiotics showed a stable trend.The resistance rate to aminoglycoamine antibiotics was lower(<20.0%).Imipenem had higher CRPA detection sensitivity than meropenem(P<0.05).The detection rates of imipenem were 90.22%and 69.57%,respectively.The detection rate of imipenem was 90.22%and 69.57%,respectively.The main clinical treatment was the combination of two or three antibiotics(70.65%).More than 50%of the patients received glucocorticoid anti-inflammatory therapy.Conclusion Respiratory tract infection is the main cause of CRPA in our hospital,which is more common in respiratory medicine department and severe medical department.Its infection will increase the economic burden of patients and the length of stay in hospital.Clinical and infection prevention and control departments should take measures to reduce its prevalence.

关 键 词：铜绿假单胞菌 青霉素酰胺酶 抗药性 细菌 β内酰胺抗药性 经济损失 住院天数 

分 类 号：R446.5[医药卫生—诊断学]