某综合性医院铜绿假单胞菌感染特点及耐药变迁  

Characteristics and drug resistance of Pseudomonas aeruginosa infection in a general hospital

作　　者：王丽[1] 崔琢[1] 郭普[2] 张向君[1] 朱敬蕊[1] WANG Li;CUI Zhuo;GUO Pu;ZHANG Xiangjun;ZHU Jingrui(Department of Hospital Infection Management,the First Afiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院医院感染管理科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院检验科

出　　处：《中华全科医学》2023年第9期1495-1497,1575,共4页Chinese Journal of General Practice

基　　金：安徽省高校自然科学研究项目(KJ2021A0761);蚌埠医学院科技项目(人文社会科学重点项目,2021byzd278sk)。

摘　　要：目的 研究医院铜绿假单胞菌感染的临床分布特点及耐药性变迁,为医院感染防控和合理使用抗菌药物提供依据。方法 通过检索电子病历系统和医院感染实时监测系统调查病例资料,查阅2019年1月—2021年12月某综合性医院住院患者的铜绿假单胞菌感染分布和耐药情况,应用Whonet 5.6软件和SPSS 25.0统计学软件对相关资料进行统计学分析。结果 2019—2021年该院住院患者中共检出非重复铜绿假单胞菌1 106株,以重症监护病房检出率最高(25.68%),其次是急诊科(9.22%)和呼吸内科(8.2.3%)。在送检的各类标本中呼吸道标本的检出率占63.02%,其次是脓液(9.40%)、尿液标本(3.44%)。检出的铜绿假单胞菌对临床常用抗菌药物出现不同程度耐药,其中耐药率最高的是环丙沙星(37.79%),耐药率最低的是阿米卡星(18.90%)。连续3年对亚胺培南、环丙沙星的耐药率均超过30%。对头孢吡肟、氨曲南、妥布霉素、庆大霉素、阿米卡星的耐荷药率呈下降趋势,3年间耐药率差异均有统计学意义(均P<0.05)。3年间左氧氟沙星和环丙沙星的耐药率波动差异有统计学意义(P<0.05)。结论 该医院铜绿假单胞菌感染主要分布在重症监护病房,以呼吸道感染为主,3年间对临床常用抗菌药物耐药率呈现不同的趋势变化,耐碳青霉烯类铜绿假单胞菌菌株依然是临床关注的重点之一。在今后临床工作中需要持续监测铜绿假单胞菌流行情况和耐药性变迁,以提供有效的感染防控依据。ObjectiveeTo study the clinical distribution characteristics and drug resistance changes of Pseudomonas aeruginosa infection in hospital,so as to provide basis for prevention and control of hospital infection and rational use of antibacterial drugs.Methods The distribution and drug resistance of Pseudomonas aeruginosa in hospitalized patients from January 2019 to December 2021 were searched by electronic medical record system and hospital infection real-time monitoring system.The relevant data were statistically analyzed by Whonet 5.6 software and SPSS 25.0.Results A total of 1106 strains of non-duplicated Pseudomonas aeruginosa were detected in hospitalized patients from 2019 to 2021,with the highest detection rate in intensive care units(25.68%),followed by emergency departments(9.22%)and respiratory departments(8.23%).Among all kinds of samples submitted for examination,respiratory tract samples accounted for 63.02%,followed by pus(9.40%)and urine samples(3.44%).The detected Pseudomonas aeruginosa showed different degrees of resistance to commonly used clinical antimicrobials,with the highest resistance rate being ciprofloxacin(37.79%)and the lowest resistance rate being amikacin(18.90%).The resistance rate to imipenem and ciprofloxacin exceeded 30%for 3 consecutive years.The resistance rates to cefepime,aztreonam,tobramycin,gentamicin and amikacin showed a downward trend,and the differences in resistance rates during the three years were statistically significant(all P<0.05).The fluctuation of levofloxacin and ciprofloxacin resistance rate during three years was statistically different(P<0.05).Conclusion The infection of Pseudomonas aeruginosa is mainly distributed in the intensive care unit,mainly respiratory tract infection,and the resistance rate to common clinical antibiotics shows different trends in the past 3 years.Carbapenem-resistant Pseudomonas aeruginosa strains are still one of the focuses of clinical attention.In the future clinical work,it is necessary to continuously monitor the prevalence and

关 键 词：铜绿假单胞菌 医院感染 临床分布 耐药性 

分 类 号：R372[医药卫生—病原生物学] R378.991[医药卫生—基础医学]