2092株铜绿假单胞菌医院感染的临床分布及耐药性分析

Clinical distribution and drug resistance of 2092 strains of Pseudomonas aeruginosa causing nosocomial infections

目的调查医院铜绿假单胞菌的临床分布和耐药性,为临床治疗铜绿假单胞菌感染提供参考依据。方法对医院2007年7月-2011年3月住院患者送检的各类标本进行病原菌培养与鉴定,药敏试验采用纸片扩散法,使用WHONET 5.4软件进行耐药性分析。结果共分离2092株铜绿假单胞菌,占分离病原菌总数的23.3%;其中呼吸道标本1748株;2092株铜绿假单胞菌中集中分布在ICU、干部病房、呼吸内科、神经内科和神经外科共1758株,占总数的84.0%;耐药率最高的是磺胺甲噁唑/甲氧苄啶,为71.8%,最低的是头孢哌酮/舒巴坦,为15.6%,对亚胺培南和美罗培南的耐药率为39.8%和28.3%。结论了解铜绿假单胞菌临床分布并动态监测其耐药性,可指导临床合理使用抗菌药物,并有效控制和延缓细菌耐药的发生。

OBJECTIVE To investigate the clinical distribution and drug resistance of Pseudomonas aeruginosa and to provide the reference for clinical treatment of P. aeruginosa infections. METHODS Various types of specimens were collected from the hospitalized patients from Jul 2007 to Mar 2011, the bacterial culture and identification were performed, the drug susceptibility testing was carried out by Kirby-Bauer method, the statistical analysis of drug resistance was performed by using WHONET 5. 4 software. RESULTS A total of 2092 strains of P. aeruginosa were isolated, accounting for 23.3% ,among which 1748 strains were isolated from the respiratory tract. Most of the 2092 strains distributed intensively in the ICU, department of cadre ward, department of respiratory internal medicine, department of neurology, and department of neurosurgery, accounting for 84.0 %. The antibiotics resistance rate to sulfamethoxazole / trimethoprim was the highest （71.8%）, the cefoperazone/ sulbactam the lowest （15.6%）, the drug resistance rates to imipenem and meropenem were 39.8% and 28.3%, respectively. CONCLUSION To understand the clinical distribution of P. aeruginosa strains and monitor its drug resistance dynamically can guide the reasonable use of antibiotics as well as control and delay the emergence of drug resistant strains.