老年慢性下呼吸道感染患者铜绿假单胞菌感染及耐药性分析  

Analysis of Pseudomonas aeruginosa infection and drug resistance in elderly patients with chronic lower respiratory tract infections

作　　者：白云[1] 许丽娜 康瑞[2] Bai Yun;Xu Lina;Kang Rui(Department of Laboratory Medicine,Zhoukou Central Hospital,Zhoukou 466000,China;Department of Ophthalmology and Otolaryngology,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]河南省周口市中心医院检验科,466000 [2]河南省周口市中心医院耳鼻喉科,466000

出　　处：《中国实用医刊》2021年第4期72-75,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析老年慢性下呼吸道感染患者铜绿假单胞菌感染及耐药性。方法收集2017年1月至2019年12月周口市中心医院收治的500例老年慢性下呼吸道感染患者的痰标本,共分离培养出铜绿假单胞菌菌株215份,实施体外药敏试验,对其敏感性和耐药性进行分析。结果500份痰标本共分离培养出铜绿假单胞菌菌株215份,阳性检出率为43.00%。体外药敏试验结果显示,14种抗菌药物中,铜绿假单胞菌耐药率高于20%,包括左旋氧氟沙星30.23%、诺氟沙星23.72%、环丙沙星21.86%,亚胺培南、头孢他啶、替卡西林/克拉维酸、哌拉西林、庆大霉素、氨曲南、美洛培南、妥布霉素、头孢吡肟、头孢哌酮/舒巴坦、阿米卡星耐药率均低于20%,其中阿米卡星最低,为10.23%;对215株铜绿假单胞菌进行β-内酰胺酶测定,共测出β-内酰胺酶阳性菌60株,检出率为27.91%。对60株β-内酰胺酶阳性菌进行药敏试验结果显示,其对左旋氧氟沙星、诺氟沙星、替卡西林/克拉维酸、哌拉西林、庆大霉素、美洛培南、妥布霉素、头孢吡肟、头孢哌酮/舒巴坦、阿米卡星耐药率均高于50%,对亚胺培南、头孢他啶、氨曲南耐药率相对较低,分别为20.00%、20.00%、16.67%。结论铜绿假单胞菌在老年慢性下呼吸道感染患者中感染率较高,尤其是β-内酰胺酶阳性菌对多种抗生素具有强耐药性,亚胺培南、氨曲南、阿米卡星药敏性相对较高。Objective To analyze Pseudomonas aeruginosa infection and drug resistance in elderly patients with chronic lower respiratory tract infections.Methods The sputum specimens of 500 elderly patients with chronic lower respiratory tract infections in Zhoukou Central Hospital from January 2017 to December 2019 were included.A total of 215 Pseudomonas aeruginosa strains were isolated and cultured.In vitro drug sensitivity assay was performed to analyze the sensitivity and drug resistance.Results A total of 215 Pseudomonas aeruginosa strains were isolated and cultured from 500 sputum samples,with a positive detection rate of 43.00%.The results of in vitro drug sensitivity assay showed that among the 14 antibacterial drugs,the resistance rate of Pseudomonas aeruginosa was higher than 20%,including Levofloxacin(30.23%),Norfloxacin(23.72%)and Ciprofloxacin(21.86%),and the resistance rates of Imipenem,Ceftazidime,Ticarcillin/Clavulanic acid,Piperacillin,Gentamicin,Aztreonam,Meropenem,Tobramycin,Cefepime,Cefoperazone/Sulbactam and Amikacin were all less than 20%.Amikacin had the lowest resistance rate oh 10.23%.β-lactamase detection was performed on 215 strains of Pseudomonas aeruginosa,and a total of 60 strains ofβ-lactamase-positive bacteria were detected,with a detection rate of 27.91%.The results of drug sensitivity assay on 60 strains ofβ-lactamase-positive bacteria showed that the resistance rates of Levofloxacin,Norfloxacin,Ticarcillin/Clavulanic acid,Piperacillin,Gentamicin,Meropenem,Cephalosporin,Tobramycin,Cefepime,Cefoperazone/Sulbactamand Amikacin were higher than 50%,and the resistance rates of Imipenem,Ceftazidime and Aztreonam were relatively lower in 20.00%,20.00%and 16.67%respectively.Conclusions Pseudomonas aeruginosa has a higher infection rate in elderly patients with chronic lower respiratory tract infections,and theβ-lactamase-positive bacteria has strong resistance to many antibacterial drugs.Imipenem,Aztreonam and Amikacin have relatively better sensitivities to Pseudomonas aeruginosa.

关 键 词：呼吸道感染 铜绿假单胞菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R56[医药卫生—临床医学]