多药耐药铜绿假单胞菌感染的调查分析

Investigation and analysis of multidrug-resistant Pseudomonas aeruginosainfections

目的为了解医院多药耐药铜绿假单胞菌感染及耐药性和评价"创三甲"及"优质护理服务"对多药耐药铜绿假单胞菌的控制效果,以降低多药耐药菌的检出率。方法回顾性分析2009年11月-2011年10月960株铜绿假单胞菌感染及耐药性特点,并对医院管理改革前后的比较分析。结果医院多药耐药铜绿假单胞菌371株,检出率为38.6%,其中有84.1%分离自呼吸道标本,科室分布以重症监护病房(ICU)为最多34.2%;按年份分组比较分析显示,执行新医院管理措施后多药耐药铜绿假单胞菌的检出率由46.1%降至28.0%,差异有统计学意义(P<0.01);铜绿假单胞菌对常见7种抗菌药物头孢吡肟、左氧氟沙星、环丙沙星、庆大霉素、阿米卡星、亚胺培南和美罗培南敏感性显著提高(P<0.01)。结论医院管理改革是有效降低多药耐药铜绿假单胞菌的检出率和提高其对抗菌药物的敏感性主要因素,值得进一步推广和加强。

OBJECTIVE To investigate the drug resistance of multidrug-resistant Pseudornonas aeruginosa causing infection and evaluate the effect of three A strive arid good quality of nursing service on the control of multidrug-resistant P. aeruginosa so as to reduce the detection rate of the muhidrug-resistant strains. METHODS From Nov 2009 to Oct 2011, the incidence of the infections caused by 960 strains of P. aeruginosa and the drug resistance were retrospectively analyzed and compared before and after the reform of hospital management. RESULTS Totally 371 strains of muhidrug-resistant P. aeruginosa have been isolated with the detection rate of 38.6%, among which 84.1 % were isolated from the respiratory tract specimens; 34.2% of the strains were distributed in the intensive care unit （ICU）. The result of the comparison through grouping in different years indicated that the detection rate of multidrug-resistant P. aeruginosa decreased from 46.1% to 28.0% after the new hospital management meas- ures were implemented, the difference was statistically significant （P〈0.01）. The drug susceptibilities of the P. aeruginosa strains to the 7 commonly used antibiotics, including cefepime, levofloxacin, ciprofloxacin, gentami-cin, amikacin, imipenem, and meropenem, were significantly increased （P〈0.01）. CONCLUSION The hospital management reform can effectively reduce the detection rate of mutldrug-resistant P. aeruginosa and raise the drug susceptibility, which should be further promoted and intensified.