摘要
目的探讨老年患者医院感染铜绿假单胞菌(PAE)临床特点及耐药性,为临床医师治疗医院感染选择合适的抗菌药物提供实验室依据。方法回顾性调查医院2009年1月-2012年12月老年患者感染的338株铜绿假单胞菌在各类感染性标本中的分布及对抗菌药物的耐药率,细菌感染标本的无菌取材、细菌的分离培养与种型鉴定严格按照卫生部《全国临床检验操作规程》进行;药敏试验和结果评价采用WHO和CLSI推荐的K-B法和最新折点进行;数据处理采用WHONET5.4-5.5软件分析。结果 338株铜绿假单胞菌医院感染的高发部位主要是呼吸道和泌尿道,分别占53.0%和20.7%;老年患者医院感染的好发年龄>70岁,占86.1%;铜绿假单胞菌耐药率>40.0%的抗菌药物有磺胺甲噁唑/甲氧苄啶、头孢噻肟、头孢吡肟、庆大霉素、哌拉西林、环丙沙星、左氧氟沙星,耐药率<10.0%的抗菌药物有阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌啦西林/他唑巴坦;检出耐亚胺培南铜绿假单胞菌29株,检出率为8.6%。结论老年患者铜绿假单胞菌医院感染的概率很高,其对临床常用抗菌药物的耐药性不断上升,检验科应与医院感染管理部门和临床科室联手,加强跟踪监测措施,以预防与控制铜绿假单胞菌医院感染的发生与扩散。
OBJECTIVE To investigate the clinical characteristics and antimicroblai remstance of seuaomonas aeruginosa （PAE） causing nosocomial infections in senile patients in grass-root hospital to provide the reference for the clinical use of antibiotics. METHODS Constituent ratio of 338 PAE in various types of infectious specimens and resistance were reviewed retrospectively in two hospitals from Jan. 2009 to Dec. 2012. Referring to National Guide to Clinical Laboratory Procedures, the infective specimens were collected to perform the bacterial culturation and identification. The drug-sensitivity testing was performed by K-B methods recommended by WHO and CLSI. The testing results were assessed. The WHONET 5.4-5.5 software was used to analyze the data. The quality control was performed before, after and throughout the testing. RESULTS The elderly patients more than 70 years old was susceptible to nosocomial infections, accounting for 86.1% of the total number of cases. Infection sites mainly were respiratory tract （179 isolates, 50.6 %） and urinary tract （70 isolates, 20.7 % ）. The susceptibility testing results indicated that 29 imipenem-resistant PAE accounted for 8. 6%0. The antibiotics with more than 40.0% of resistance rate were SMZ-TMP, cefotaxime, cefepime, gentamycin, piperacillin, ciprofloxacin, levofloxacin. The antibiotics with less than 10.0% of resistance rate were amikacin, imipenem, meropenem and cefoperazone/sulbactam and piperacillin/tazobatam. CONCLUSION Incidence of nosocomial infection caused by PAE in senile was high. The drug-resistance of PAE was increasingly severe. Depa tment of clinical laboratory should assist management of nosocomial infections, strengthen the monitoring and raise detection ability to prevent and control the outbreak and prevalence.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第11期2657-2659,共3页
Chinese Journal of Nosocomiology
基金
黄石市科技计划基金资助项目(2011A045-5)
关键词
老年患者
铜绿假单胞菌
医院感染
耐药性
Senile patients
Pseudomonas aeruginosa
Nosocomial infections
Antimicrobial resistance
