摘要
目的了解医院获得性铜绿假单胞菌感染的临床分布特点及耐药性,以指导临床合理使用抗菌药物提供依据。方法收集2010年1月-2012年12月住院患者标本中分离出的1 814株铜绿假单胞菌,按照《全国临床检验操作规程》进行菌株培养分离,并使用VITEK-2细菌鉴定及药敏分析系统,进行细菌鉴定和药敏试验,数据运用WHONET5.4和SPSS21.0软件进行统计分析。结果临床标本分离的病原菌中革兰阴性菌检出9 380株,其中铜绿假单胞菌检出1 814株,检出率为19.3%,检出多药耐药铜绿假单胞菌(MDRPA)312株,检出率为17.2%;铜绿假单胞菌主要分离自痰液占52.8%,其次为伤口分泌物及气管吸物,分别占18.0%、11.5%;ICU及呼吸内科检出的铜绿假单胞菌最多,分别占26.5%及21.1%;铜绿假单胞菌对哌拉西林/他唑巴坦、头孢吡肟、亚胺培南和美罗培南的耐药呈逐年下降趋势,差异有统计学意义(P<0.05)。结论医院获得性铜绿假单胞菌感染主要分布于侵入性操作多、抗菌药的应用广、住院周期长的临床科室,以呼吸道感染为主,且多药耐药菌检出率较高,严重感染可选β-内酰胺类与氨基糖苷类药物联合治疗。
OBJECTIVE To investigate the distribution and drug resistance of Pseudomonas aeruginosa ,so as to provide reference for clinical rational use of antibacterial agents .METHODS A retrospective study which applied the software WHNET5 .4 and SPSS21 .0 was conducted on 1 814 strains of P . aeruginosa isolated from the clinical specimens collected from inpatients during Jan .2010 to Dec .2012 .The bacterial culture and isolation was conducted in accordance with the National Clinical Laboratory Procedures and the BioMerieux VITEK‐2 system was used for bacterial identification and sensitivity test .RESULTS Totally 9 380 strains of gram‐negative bacteria were detected from the clinical specimens ,including 1 814 strains of P . aeruginosa with the detection rate of 19 .3% among which there were 312 strains （17 .2% ） of multidrug‐resistant P .aeruginosa （MDRP） .P .aerugi‐nosa causing hospital‐acquired infections were found frequently in intensive care unit （26 .5% ） and the department of respiration medicine （21 .1% ） , and the common types of specimens were sputum （52 .8% ） , secretions （18 .1% ） and tracheal aspirate （11 .5% ） . The drug resistance rates to piperacillin/tazobactam , cefepime , imipenem and meropenem were significantly declined year by year （P〈0 .05） .CONCLUSION Hospital‐acquired infections caused by P . aeruginosa distributed in the departments of multi‐invasive operations ,widely use of antibiotics and long periods of hospitalization .Respiratory tract infection was prevalent and the separation rate of MDRP was high . The optional treatment for severe infections was β‐lactam inhibitors combined with aminoglycoside drugs .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第12期2681-2683,共3页
Chinese Journal of Nosocomiology
基金
广西壮族自治区卫生厅科研基金资助项目(Z2011436)
关键词
医院获得性感染
铜绿假单胞菌
耐药率
Hospital-acquired infections
Pseudomonas aeruginosa
Drug resistance rates
