2019~2023年患者血流感染铜绿假单胞菌耐药特征分析  

An Analysis of Antibiotic Resistance Characteristics of Pseudomonas aeruginosa in Bloodstream Infections from 2019 to 2023

作　　者：张小艳 赵越 林乘龙 ZHANG Xiaoyan;ZHAO Yue;LIN Chenglong(Department of Clinical Laboratory,Guangdong Workers’Hospital,Guangzhou 510720,China;Department of Clinical Laboratory,Guangdong Provincial People’s Hospital/GuangdongAcademy of Medical Sciences,Southern Medical University,Guangzhou 510080,China)

机构地区：[1]广东省工人医院检验科,广东广州510720 [2]南方医科大学附属广东省人民医院/广东省医学科学院检验科,广东广州510080

出　　处：《标记免疫分析与临床》2024年第9期1670-1674,共5页Labeled Immunoassays and Clinical Medicine

基　　金：广东省基础与应用基础研究基金(编号:2021A1515220022)。

摘　　要：目的探讨血流感染患者中铜绿假单胞菌的耐药特征及其变化趋势。方法收集2019年1月至2023年12月广东省人民医院,通过血培养分离出的铜绿假单胞菌158株,采用VITEK MS和VITEK 2 Compact微生物鉴定仪进行菌株鉴定和药敏试验,并用SPSS 22.0和Whonet 5.6统计软件分析数据。结果2019~2023年临床送检的血培养共分离出病原菌4024株,其中铜绿假单胞菌158株,占比3.93%。分析发现耐碳青霉烯类铜绿假单胞菌(CRPA)的检出率有所增加,共检出30株,占比18.99%。CRPA对亚胺培南、美罗培南、氨曲南、头孢吡肟等抗菌药物的耐药率分别为92.9%、78.6%、44.4%和32.1%,且CRPA对各类抗菌药物的耐药率显著高于碳青霉烯敏感的铜绿假单胞菌(CSPA)(P<0.001)。此外,患者的年龄分布集中在>60岁,占比50.00%,主要分布于血液科、重症监护室和急诊重症监护室。结论铜绿假单胞菌在血流感染中的耐药性逐年增加,尤其是CRPA的检出率上升,影响患者预后。临床需合理选用抗菌药物,并采取有效措施,加强对耐药菌的监测和防控。Objective To investigate the antibiotic resistance characteristics and to identify trends of Pseudomonas aeruginosa in patients with bloodstream infections.Methods A total of 158 strains of Pseudomonas aeruginosa isolated from blood cultures at Guangdong Provincial People’s Hospital between January,2019 and December,2023 were collected for the study.Strain identification and antibiotic susceptibility tests were conducted using the VITEK MS and VITEK 2 Compact systems.The produced datasets were analyzed using SPSS 22.0 and Whonet 5.6 statistical softwares.Results From 2019 to 2023,a total of 4024 pathogenic strains were isolated from clinical blood cultures,with Pseudomonas aeruginosa accounting for 158 strains(3.93%).The detection rate of carbapenem-resistant Pseudomonas aeruginosa(CRPA)increased,with 30 CRPA strains identified,accounting for 18.99%of the total.The resistance rates of CRPA to imipenem,meropenem,aztreonam,and cefepime were 92.9%,78.6%,44.4%,and 32.1%,respectively.Additionally,CRPA exhibited significantly higher resistance rates to various types of antibiotics compared to carbapenem-sensitive Pseudomonas aeruginosa(CSPA)(P<0.001).The age distribution of studied patients was concentrated in the group of over 60 years old,accounting for 50.00%,and primarily distributed in the Hematology Department,Intensive Care Unit(ICU),and Emergency ICU.Conclusion The antibiotic resistance of Pseudomonas aeruginosa in bloodstream infections has increased annually,particularly with a rise in the detection rate of CRPA,which can impact patient prognosis.Clinicians should select antibiotics rationally and implement effective measures to strengthen the monitoring and control programs of resistant bacteria.

关 键 词：血流感染 铜绿假单胞菌 耐药性 碳青霉烯类药物 药敏试验 

分 类 号：R378[医药卫生—病原生物学]