老年呼吸道感染铜绿假单胞菌感染及耐药性分析  

Pseudomonas aeruginosa infection and drug resistance in the elderly with respiratory tract infection

作　　者：范雪芳 肖瑜 段玲 李红永 FAN Xuefang;XIAO Yu;DUAN Ling;LI Hongyong(Department of Infectious Diseases,General Hospital of Western Theater Command,Chengdu,Sichuan 610000,China)

机构地区：[1]西部战区总医院感染科,四川成都610000

出　　处：《公共卫生与预防医学》2023年第6期140-143,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的分析老年呼吸道感染铜绿假单胞菌(pseudomonas aeruginosa,PA)感染及耐药性,为医院感染防控及抗菌药物的合理使用提供依据。方法收集2020年3月~2022年3月期间住院老年呼吸道感染患者送检样本,对PA感染/定植情况进行调查并参考2019版CLSI标准判定分离株耐药性。结果从老年呼吸道感染患者的痰液及纤支镜灌洗液中分离123株PA,检出科室以呼吸科、ICU病房、神经内科为主,不同年份之间检出分布比较差异无统计学意义(P>0.05);2021年份院感比率44.44%低于2020年份的63.33%(χ^(2)=4.410,P=0.036);123株分离的PA菌株对哌拉西林耐药率高于90.00%,对头孢他啶、头孢噻肟、头孢吡肟、氨曲南、庆大霉素呈不同程度耐药性,不同年份之间分离的PA菌株对抗菌药物耐药率比较差异无统计学意义(均P>0.05);123株病原株中共检出17株耐碳青霉烯类PA(13.82%),且对常用抗菌药物的耐药性均显著高于碳青霉烯类敏感PA菌株(P<0.05)。结论PA分离株以医院感染为主且院感比率呈降低趋势,耐碳青霉烯类PA检出率较高,临床可使用针对性抗菌药物。Objective To analyze pseudomonas aeruginosa(PA)infection and drug resistance in the elderly with respiratory tract infection,so as to provide a basis for the control of nosocomial infection and rational use of antibiotics.Methods The samples from elderly inpatients with respiratory tract infection were collected between March 2020 and March 2022.PA infection/colonization were investigated,and the drug resistance of pathogens was determined according to CLSI criteria(2019 version).Results There were 123 strains of PA isolated from the sputum and bronchoscopy lavage fluid of elderly patients with respiratory tract infection.The main departments with positive PA detection were respiratory department,ICU ward and neurology department.The difference of PA detection in different years was not statistically significant(P>0.05).The proportion of nosocomial infection in 2021 was lower than that in 2020(44.44%vs 63.33%,χ^(2)=4.410,P=0.036).The resistance rate of 123 isolated PA strains to piperacillin was>90.00%,and they were resistant to ceftazidime,cefotaxime,cefepime,aztreonam and gentamicin to varying degrees.There was no significant difference in resistance rate of PA to antibiotics in different years(P>0.05).In the 123 strains of pathogens,there were 17 strains(13.82%)of carbapenemresistant PA,and their resistance to common antibiotics was significantly higher than that of carbapenem-sensitive PA(P<0.05).Conclusion The main pathogen of nosocomial infection is PA,and the proportion of nosocomial infection shows a downward trend.The detection rate of carbapenem-resistant PA is high.In clinical treatment,targeted antibiotics can be applied.

关 键 词：老年人 呼吸道感染 铜绿假单胞菌 耐药性 

分 类 号：R181[医药卫生—流行病学]