县级医院铜绿假单胞菌临床分布及耐药性分析

Clinical distribution and drug resistance of Pseudomonas aeruginosa in a country-level hospital

目的探讨三峡库区县级医院铜绿假单胞菌的耐药特点,为库区基层医院临床医师合理用药提供理论依据。方法采用WHONET软件统计分析65株铜绿假单胞菌的临床分布特点及耐药率。结果铜绿假单胞菌临床分离率内科为40.0%,居首位;其中以>60岁老年患者居多,占49.3%;临床标本中痰液分离率最高达80.0%;铜绿假单胞菌对13种常用抗菌药物的耐药监测结果显示,其对氟喹诺酮类抗菌药物环丙沙星的耐药率最高为43.1%,对碳青霉烯类抗菌药物亚胺培南和美罗培南耐药率均为7.7%。结论作为三峡库区县级医院,铜绿假单胞菌的耐药率与上级医院耐药率相比,远远低于上级医院,有其自身特点;但已出现碳青霉烯类抗菌药物亚胺培南、美罗培南的耐药菌株,应引起临床医师的高度关注。

OBJECTIVE To approach the drug resistance of clinically isolated Pseudomonas aeruginosa in a country level hospital in three gorges reservoir area so as to offer the clinicians in the grass-roots hospital of the reservoir area the theoretical basis for the reasonable use of antibiotics.METHODS The characteristics of clinical distribution and the drug resistance rate of 65 strains of P.aeruginosa were statistically analyzed by the use of WHONET.RESULTS Of all the clinical isolates of P.aeruginosa,40.0% were isolated from the department of internal medicine,ranking the first place;49.3% were isolated from the patients with more than 60 years of age;80.0% were isolated from clinical sputum specimens.The drug susceptibility testing of the P.aeruginosa strains to 13 antibiotics showed the drug resistance rate to the carbopenems such as imipenem was the highest（43.1%） and that the drug resistance rate to carbapenems antibiotics such as meropenem and imipenem was 7.7%.CONCLUSION The drug resistance rate of the P.aeruginosa strains isolated from the country-level hospital in the reservoir area is significantly lower than that of the strains isolated from the higher level hospitals and is with its own characteristics;however,the strains resistant to the carbapenems antibiotics such as impenem and imipenem have emerged,which the clinicians should attach great importance to.