摘要
目的分析医院铜绿假单胞菌的临床分布、耐药性变化及常用抗菌药物的临床应用情况,为临床合理使用抗菌药物、有效控制感染提供参考依据。方法选择2012年1月~2014年12月间859株铜绿假单胞菌的分布及耐药率进行回顾性分析,采用用药频度、使用强度等指标,对同期抗菌药物使用情况进行分析。结果共分离出859株铜绿假单胞菌,其中多重耐药菌株分离率19.0%,泛耐药菌株分离率5.5%;菌株主要分离自痰液（583株）和烧伤标本（110株）,分别占67.9%、12.8%;耐药监测显示：铜绿假单胞菌对阿米卡星、哌拉西林他唑巴坦、庆大霉素耐药率均〈10.0%,对美罗培南、哌拉西林、环丙沙星、头孢吡肟、头孢他啶、亚胺培南、左氧氟沙星、氨曲南耐药率在12.4%~23.9%;用药频度结果显示头孢呋辛、头孢哌酮/舒巴坦、左氧氟沙星使用强度连续3年保持前4位,美罗培南、亚胺培南使用强度保持较低水平,氨曲南使用强度大幅下降。结论铜绿假单胞菌主要致呼吸道和烧伤创面感染。2012~2014年铜绿假单胞菌检出率呈上升趋势,但多重耐药和泛耐药菌株检出率呈下降趋势,铜绿假单胞菌对常用抗菌药物耐药率呈下降趋势,应继续加强耐药性监测,合理应用抗菌药物。
Objective To analyze the clinical distribution and change of antimicrobial resistance of Pseudomonas aeruginosa and observe the use of clinical antibiotics so as to provide guidance for the rational use of antibiotics and the effective control of infection. Methods Retrospective review on distribution and antimicrobial resistance of the 859 strains Pseudomonas aeruginosa collected from January 2012 to December 2014, the use of corresponding antibiotics was analyzed in terms of DDDs and use intensity. Results A total of 859 P. aeruginosa strains were isolated, mostly from sputum specimens（583 strains, 67.9%） and burn specimens（110 strains, 12.8%）. The isolation rate of multi-drug resistant P. aeruginosa（MDRPA） was 19.0% and the isolation rate of pan-drug resistant P. aeruginosa（PDRPA） was 5.5%.According to the resistance monitoring results, the antimicrobial resistance rate of P. aeruginosa to amikacin,piperacillin-tazobactam and gentamicin were less than 10.0%, the antimicrobial resistance rate to meropenem,piperacillin, ciprofloxacin, cefepime, ceftazidime, imipenem, levofloxacin and aztreonam varied at 12.4%-23.9%. The DDDs showed that the use intensity of cefuroxime, cefoperazone-sulbactam and levofloxacin ranked in the top 4 for three consecutive years, while that of meropenem and imipenem stayed a relatively low level, the use intensity of aztreonam reduced substantially. Conclusion P. aeruginosa was the main cause of respiratory tract and burn wound infection, the detection rate of showed an upward trend from 2012 to 2014, while the detection rate of multi-drug resistant P. aeruginosa（MDRPA） and pan-drug resistant P. aeruginosa（PDRPA） has declined. The resistance rate of P. aeruginosa to commonly used antimicrobial agents was decreased. Therefore, the work of monitoring drug resistance and promoting rational application of antibiotics should be strengthened.
出处
《中国现代医生》
2015年第35期70-73,76,共5页
China Modern Doctor
关键词
铜绿假单胞菌
耐药性
抗菌药物
用药频度
使用强度
Pseudomonas aeruginosa
Antimicrobial resistance
Antibiotics
DDDs
Use intensity
