2016—2020年肿瘤患者铜绿假单胞菌感染及耐药趋势分析  

Retrospective study of pseudomonas aeruginosa infection and drug resistance in tumor patients from 2016 to 2020

作　　者：霍然 李俊毅 陈丽妹[1] 辛娜[1] 陈岩松[1] 陈燕 HUO Ran;LI Junyi;CHEN Limei;XIN Na;CHEN Yansong;CHEN Yan(Fujian Cancer Hospital,Clin Gical Oncology School of Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学肿瘤临床医学院,福建省肿瘤医院,福州350014 [2]福建医科大学医学技术与工程学院

出　　处：《福建医药杂志》2023年第1期19-22,共4页Fujian Medical Journal

摘　　要：目的 探讨肿瘤患者感染铜绿假单胞菌(PA)的临床分布、耐药趋势,为肿瘤患者PA感染治疗提供依据。方法 回顾性分析2016-2020年我院临床标本分离出PA的肿瘤患者的临床资料及药敏试验数据。结果 2016年1月至2020年12月我院共分离出PA 926株,临床患者标本来源主要为呼吸道标本(65.12%)。2016—2020年我院PA对亚胺培南的总体耐药率为31.42%,对美罗培南的总体耐药率为23.11%,对庆大霉素、环丙沙星、头孢他啶的总体耐药率分别为8.74%、16.41%、15.23%,对头孢吡肟、左氧氟沙星、哌拉西林、哌拉西林/他唑巴坦的总体耐药率分别为10.48%、13.39%、12.20%、11.12%。我院PA分离率与细菌耐药监测官网(CHINET网,http://www.chinets.com)监测数据差异无统计学意义(P>0.05);但对亚胺培南耐药率高于CHINET监测数据,对左氧氟沙星、头孢吡肟、哌拉西林、哌拉西林/他唑巴坦耐药率低于CHINET监测数据(均P<0.05)。结论 PA是我院内检出率较高的条件致病菌之一,应高度警惕耐药菌株的产生。我院PA对常用抗生素耐药呈下降趋势;但对于某些抗生素耐药性高于同一时期CHINET监测数据。临床工作中应密切监测肿瘤患者PA感染及耐药情况,同时在治疗中合理使用抗菌药物,预防耐药菌株的产生。Objective To explore the clinical distribution and drug resistance trend of pseudomonas aeruginosa(PA) infection in tumor patients, and to provide evidence for the treatment of PA infection in tumor patients.Methods Clinical data and drug sensitivity test data on tumor patients with PA isolated from clinical specimens in our hospital from 2016 to 2020 were analyzed retrospectively.Results A total of 926 PA were detected from Jan.2016 to Dec.2020.The specimens were mainly from respiratory tract(65.12%).From 2016 to 2020, the overall drug resistance rate of PA in our hospital to imipenem was 31.42% and the overall drug resistance rate to meropenem was 23.11%.The overall drug resistance rates to gentamicin, ciprofloxacin and ceftazidime were 8.74%, 16.41% and 15.23%, respectively.There was no significant difference between the isolated rate of PA from our hospital and data on the official website of bacterial resistance monitoring(CHINET, http://www.chinets.com), while the drug resistance rate to imipenem is higher than that of CHINET data and the drug resistance rate to levofloxacin, cefepime, piperacillin, piperacillin/tazobactam were all lower than the data on CHINET.Conclusion We should be highly alert to the emergence of drug-resistant strains because PA was one of the conditional pathogens with high detection rate in our hospital.The resistance of PA isolated from our hosptial to common antibiotics was declining but the drug resistance to some antibiotics was higher than that of CHINET in the same period.In clinical work, we should monitor the PA infection and drug resistance in tumor patients closely, and at the same time, we should use antibiotics reasonably to prevent the emergence of drug resistant strains in the treatment of PA infection.

关 键 词：铜绿假单胞菌 肿瘤患者 耐药性 抗生素 

分 类 号：R378[医药卫生—病原生物学]