近5年铜绿假单胞菌和大肠埃希菌的耐药变迁研究

Research of Pseudomonas aeruginosa and Escherichia coli resistance changes in recent 5 years

目的了解该院近5年来临床常见的铜绿假单胞菌和大肠埃希菌耐药性的动态变化情况以及在不同标本间的差异。方法采用回顾性分析方法,对2007年10月至2012年9月临床分离的铜绿假单胞菌和大肠埃希菌对21种抗菌药物的耐药情况进行统计分析。结果铜绿假单胞菌和大肠埃希菌的临床分离株数量呈逐年上升的趋势。抗菌药物的耐药率均处于下降的趋势,而且有的抗菌药物耐药率下降变化差异有统计学意义(P<0.05);部分抗菌药物的耐药性出现波动性变化。从痰标本和血标本分离的铜绿假单胞菌的耐药率差异无统计学意义(P>0.05),而大肠埃希菌却有6种抗菌药物的耐药率比较差异有统计学意义(P<0.05)。从血标本和尿标本分离的铜绿假单胞菌,左氧氟沙星和环丙沙星的耐药率差异有统计学意义(P<0.05),大肠埃希菌对头孢他啶、头孢噻肟和亚胺培南的耐药率差异有统计学意义(P<0.05),其他抗菌药物的耐药率比较差异无统计学意义(P>0.05)。从呼吸内科和ICU痰标本分离的铜绿假单胞菌的耐药率差异有统计学意义(P<0.01),而大肠埃希菌有12种抗菌药物的耐药率比较差异无统计学意义(P>0.05)。结论抗菌药物的耐药率均处于下降的趋势,说明抗菌药物使用的控制措施出现了成效;铜绿假单胞菌和大肠埃希菌的耐药情况因来自不同标本和不同科室发生不同的变化,对指导临床用药有重要意义。

Objective To investigate the resistance dynamic changes of Pseudomonas aeruginosa and Escherichia coli for the past five years in our hospital,and resistance differences between different specimens. Methods By the retrospective analysis methods, statistical analysis of 21 kinds of antimicrobial resistance to Pseudomonas aeruginosa and Escherichia coli from 2007 October to 2012 September. Results Numbers of clinical isolates of Pseudomonas aeruginosa and Escherichia coli showed an increasing trend. The antibiotic resistance rate was in a downward trend,and the changes had a significant difference in part（P〈0.05） ;volatile chan-ges in the resistance to some antibiotics. The resistance rate of Pseudomonas aeruginosa isolated from sputum specimens and blood samples was not statistically significant（P〈0.05）, but to Escherichia coli there was a statistically significant difference for six kinds of antibiotics（P〈0.05）. Pseudomonas aeruginosa isolated from blood samples and urine samples had a statistically significant difference（P〈0.05） for levofloxacin and ciprofloxacin,and the resistance rates of ceftazidime,cefotaxime and imipenem had a sta-tistically significant difference to Escherichia coli（P〈0. 05） ,and the other antibiotics were not a statistically significant difference （P〈0.05）. The resistance rate of Pseudomonas aeruginosa isolated from the department of respiratory medicine and ICU sputum specimens was a statistically significant difference（P〈0.01）,and Escherichia coli was no statistically significant difference for 12 kinds of antibiotics（P〈0.05）. Conclusion The antibiotic resistance rate is in a downward trend,the control measures of antibiotic use appears effective. It is important to guide clinical therapy that different changes in the resistance of Pseudomonas aeruginosa and Escherichia coli from different samples and different departments.