摘要
目的探讨武汉某医院临床分离的铜绿假单胞菌(Pseudomonas aeruginosa)分布情况及常见药敏耐药性的变迁,为临床合理使用抗菌药物提供参考依据。方法对2014-01/2016-12月临床送检标本中分离出的铜绿假单胞菌标本类型、临床分布等相关资料及其药敏情况进行回顾分析。采用WHONET 5.6软件对数据进行分析,细菌鉴定及药物敏感试验采用珠海迪尔DL 96Ⅱ细菌鉴定分析仪。结果 3年共分离铜绿假单胞菌902株,总体检出率为1.52%(902/59 477)。从痰液标本中分离出602株(66.74%,602/902),其次为尿液标本中分离出145株(16.08%,145/902);分布前三位的科室分别为院重症监护病房(intensive care unit,ICU)198株(21.95%),神经内科ICU 117株(12.97%)及呼吸内科91株(10.09%);铜绿假单胞菌对临床常用的13种抗菌药物耐药率都在11%以上,耐药率最高的是哌拉西林(32.82%),耐药率最低的是氨曲南(11.53%)。耐药率呈逐年下降趋势的有氨曲南、替卡西林/克拉维酸、阿米卡星;环丙沙星和左氧氟沙星则呈逐年上升趋势。结论铜绿假单胞菌在院ICU、神经内科ICU和呼吸内科的危重病人和老年人多见,应加强护理,根据药敏结果与变迁情况选择合适有效的抗菌药物,避免多重耐药菌产生与传播。
Objective To investigate the distribution and drug resistance evolution of Pseudomonas aeruginosain a hospital in Wuhan,and provide the basis for rational use of antibiotics.Methods The clinical distribution and types of Pseudomonas aeruginosa specimens and its drug susceptibility were retrospectively analyzed from January 2014 to December 2016.All data were analyzed by WHONET 5.6,while bacterial identification and antibiotic susceptibility analysis were performed by DL 96Ⅱanalyzer.Results A total of 902 strains of Pseudomonas aeruginosa were isolated,with an overall isolation rate of 1.52%(902/59 477).Six hundred and two strains out of the 902 strains were isolated from sputum specimens(66.74%,602/902),and then 145 strains were isolated from urine specimens(16.08%,145/902).The hospital intensive care unit(ICU)(198 strains,21.95%),neurology ICU(117 strains,12.97%)and respiratory medicine department(91 strains,10.09%)were the top three departments of Pseudomonas aeruginosa detection rate.The drug resistance rates of Pseudomonas aeruginosa to the 13 antibiotics commonly used in clinic were all above 11%,the highest one was piperacillin(32.82%),and the lowest one was aztreonam(11.53%).The drug resistance of antreonam,ticarcillin/clavulanic acid and amikacin was decreased year by year,but the ciprofloxacin and levofloxacin was increased year by year.Conclusion Pseudomonas aeruginosais more common in critically ill and the elderly patients in hospital ICU,neurology ICU and respiratory medicine department,which need more attention and nursing care.According to the antibiotic susceptibility tests and the drug resistance evolution,the reasonable selection and use of antibiotic should be strengthened to avoid the generation and spread of multi-resistant bacteria.
作者
马红玲
汪玉珍
陆齐泉
宁立芬
MA Hongling;WANG Yuzhen;LU Qiquan;NING Lifen(Department of Clinical Laboratory Medicine,Wuhan Hanyang Hospital ,Wuhan Hubei 430050,China)
出处
《华南国防医学杂志》
CAS
2018年第11期765-768,共4页
Military Medical Journal of South China
关键词
铜绿假单胞菌
耐药性
耐药性变迁
抗菌药
Pseudomonas aeruginosa
Drug resistance
Drug resistance evolution
Antibiotics
