摘要
目的了解上海市某三甲医院铜绿假单胞菌(PA)临床分离株的分布,以及多重耐药PA(MDR-PA)、泛耐药PA(XDR-PA)和耐碳青霉烯类PA(CRPA)流行情况,为抗菌药物合理应用提供依据。方法收集2014-2017年临床科室培养标本中分离PA的标本信息及其药敏数据,分析PA的标本、病区来源,以及与患者年龄、性别间的关系,并计算MDR-PA、XDR-PA、CRPA的分离率。结果4年间共分离PA 1218株,分离株数呈逐年递增趋势;菌株主要分离自痰(75.0%),其次为尿(10.6%)。PA最常见于老年医学科(44.9%),其次为重症监护病房和呼吸科(各占8.9%),多分离于60岁以上人群,以男性为主。PA菌株中MDR-PA菌株的比率达30.5%,XDR-PA仅为2.5%,CRPA比率高达38.8%,均呈逐年递增趋势。MDR-PR、XDR-PA、CRPA标本来源及科室分布与PA相仿,即以痰及老年医学科为主。结论该院MDR-PA、CRPA分离率高,主要分离自痰、老年医学科,应针对不同科室及人群加强医院感染防控措施,强化抗菌药物临床使用管理,预防和控制MDR-PA、CRPA的产生和流行。
Objective To understand the distribution of clinical isolates of Pseudomonas aeruginosa(PA),prevalence of multidrug-resistant PA(MDR-PA),extensively drug resistant-PA(XDR-PA),and carbapenem-resistant PA(CRPA)in a tertiary first-class hospital in Shanghai,so as to provide evidence for rational use of antimicrobial agents.Methods Specimen information and antimicrobial susceptibility data of PA isolated from cultured specimens of clinical departments from 2014 to 2017 were collected,sources of specimens and department of PA,relationship between PA and age as well as sex of patients were analyzed,isolation rates of MDR-PA,XDR-PA and CRPA were calculated.Results A total of 1218 PA strains were isolated in the past four years,number of isolated PA increased year by year;strains were mainly isolated from sputum(75.0%),followed by urine(10.6%).PA was most common in department of geriatric medicine(44.9%),followed by intensive care unit(8.9%)and respiratory department(8.9%),PA was mostly isolated from people over 60 years old and mainly male.Among PA strains,percen-tage of MDR-PA was 30.5%,but XDR-PA was only 2.5%,while isolation rate of CRPA was up to 38.8%,which showed an increasing trend year by year.Specimen sources and department distribution of MDR-PR,XDR-PA and CRPA were similar to those of PA,that is,sputum and department of geriatrics medicine.Conclusion Isolation rate of MDR-PA and CRPA in this hospital is high,strains are mainly from sputum and department of geriatric medicine,prevention and control measures of healthcare-associated infection(HAI)should be strengthened accor-ding to different departments and populations,management of clinical use of antimicrobial agents should be strengthened to prevent and control the occurrence and prevalence of MDR-PA and CRPA.
作者
宋皓月
黄凯峰
汤荣
陈雯静
舒文
刘庆中
SONG Hao-yue;HUANG Kai-feng;TANG Rong;CHEN Wen-jing;SHU Wen;LIU Qing-zhong(Department of Clinical Laboratory,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 201620,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2019年第12期1093-1098,共6页
Chinese Journal of Infection Control
基金
国家自然科学基金(81772247、81371872)
上海交通大学“医工交叉研究基金”(YG2016QN31)
关键词
铜绿假单胞菌
临床分布
多重耐药
广泛耐药
耐碳青霉烯类
Pseudomonas aeruginosa
clinical distribution
multidrug-resistance
extensively drug resistance
carbapenem resistance
