2007-2011年铜绿假单胞菌医院感染分布及耐药性分析

Distribution and drug resistance of Pseudomonas aeruginosa causing nosocomial infections in 2007-2011

目的了解医院铜绿假单胞菌感染分布及耐药性,为医院监测控制及合理选用抗菌药物提供依据。方法对2007年1月-2011年12月分离的745株铜绿假单胞菌药敏结果进行回顾性分析,并记录其感染部位、标本分布及药敏试验。结果 2007年1月-2011年12月临床送检的各类标本中共检出铜绿假单胞菌745株,主要分布于呼吸道占92.1%,其次为尿液占5.6%;2007-2011年氨曲南的耐药率分别为46.42%、50.00%、51.60%、62.31%、67.98%,呈逐年上升趋势;亚胺培南和阿米卡星一直保持较好的抗菌活性,其最高耐药率分别为7.14%和12.79%;多药耐药铜绿假单胞菌(MDRPA)检出菌株数逐年上升,2008-2011年检出MDRPA18株,未检出泛耐药铜绿假单胞菌(PDRPA)。结论铜绿假单胞菌感染以呼吸道为主,可引起多部位感染;其具有多种耐药机制,易诱导耐药性产生,临床用药应以药敏试验结果为指导,合理使用抗菌药物,减少耐药菌株的产生。

OBJECTIVE To investigate the distribution and drug resistance of the Pseudomonas aeruginosa causing nosocomial infections so as to provide basis for the surveillance and control as well as the reasonable use of antibiotics. METHODS The result of drug susceptibility testing for 745 strains of P. aeruginosa isolated from Jan 2007 to Dec 2011 was retrospectively analyzed, then the infection sites and specimens sources were recorded. RESULTS Totally 745 strains of P. aeruginosa were isolated from the submitted specimens from Jan 2007 through Dec 2011, most of which were isolated from the respiratory tract specimens and urine specimens. The drug resistance rate of the P. aeruginosa to aztreonam was 46. 42% in 2007, 50. 00% in 2008, 51. 60% in 2009, 62.31% in 2010, and 67. 98% in 2011, showing an upward trend; P. aeruginosa strains maintained good antimicrohial activity against imipenem and amikacin, the drug resistance rates were the highest, which were 7.14% and 12.79%, respectively. The number of the isolates of multidrug-resistant P. aeruginosa increased year by year, totally 18 strains of multidrug-resistant P. aeruginosa have been detected in 2008-2011, and no strain of pandrug-resistant P. aeruginosa has been detected. CONCLUSION The P. aeruginosa is the predominant species of pathogen causing respiratory tract infections and results in infection of multiple sites; the multiple drug resistance mechanisms are prone to induce the drug resistance, therefore it is necessary for the hospital to reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the drug resistant strains.