铜绿假单胞菌临床分离株医院感染分布及耐药性

Distribution and Drug Resistance of Clinical Pseudomonas aeruginosa Isolates

目的了解铜绿假单胞菌(PAE)的感染分布及其耐药性,为临床治疗提供依据。方法采用回顾性的方法统计分析218株PAE的标本来源、感染科室分布及耐药状况。结果218株PAE有138株来自痰液及咽拭子(63.3%),25株来源于伤口拭子(11.5%),分离PAE的科室分别为重症监护病房(ICU)占44.9%、神经科占12.4%、呼吸科占11.5%;药敏结果显示,PAE对β-内酰胺类、氨基糖苷类、喹诺酮类、磺胺类抗菌药物均有很高的耐药性,耐药率均>50%,而对碳青酶烯类、β-内酰胺类及含酶抑制剂复合药有较低的耐药率,最低者是哌拉西林/他唑巴坦8.7%,其次是头孢哌酮/舒巴坦17.5%。结论PAE临床分离株多来自于痰液及咽拭子标本和ICU病房,并对多种抗菌药物的耐药率较高,多重耐药性明显,临床应加强对PAE耐药性的监控并防治耐药菌株的传播流行。

OBJECTIVE To investigate the distribution and drug resistance of clinical Pseudomonas aeruginosa isolates, and offer reasonable experimental data for clinical therapy. METHODS A statistic analysis for the specimen source, departments with infection and drug resistance condition to 218 isolates was conducted in retrospective manner. RESULTS Among 218 strains 138（63.3%） come from sputum and throat mucus, and 25 （11.5%） from wound swab, the proportion of these strains from ICU was 44.9%, from neurology department was 12.4% and from respiratory department was 11.5%. The result of drug susceptibility showed that P. aeruginosa had a high resistance rate to the β-laetamases, aminoglyeosides, fluoroquinolones and sulfanilamides antibiotics, respectively, accounted for more than 50%, and had a lower resistance rate to earbapenem, β- laetamases antibiotics/inhibitor, the lowest was to piperaeillin/tazobaetam （8. 7%）, and to cefoperazone/ sulbaetam （17.5 %）. CONCLUSIONS Clinical isolates of P. aeruginosa come from the sputum, pharyngeal swab and ICU mainly, but their resistant rates are rather high and multidrug-resistant. We should pay more attention to the surveillance of antimicrobial resistance of P. aeruginosa in clinics and prevent transmission and epidemic of their resistance strains.