某县级医院铜绿假单胞菌的分布及耐药性变迁

Distribution and antimicrobial resistance of Pseudomonas aeruginosain a county-level hospital

目的：了解近年某县级医院铜绿假单胞菌的分布及耐药特点，为临床合理用药提供依据，并有助于医院感染预防与控制。方法对该院2010-2012年临床各类标本分离的铜绿假单胞菌的资料进行统计分析。结果3年共分离铜绿假单胞菌369株，主要检出自痰液及咽拭子（234株，63．41％）、尿液（41株，11．11％）和伤口拭子（28株，7．59％）标本；在病区，主要分布于重症监护室（146株，39．56％）、呼吸内科（51株，13．82％）和神经外科（37株，10．03％）。铜绿假单胞菌对多粘菌素B无耐药；对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和阿米卡星的耐药率较低（6．81％～22．73％）；各年度相比，除多粘菌素B外，对其他抗菌药物的耐药率均有不同程度上升，部分抗菌药物具统计学意义（P＜0．05）。结论该院铜绿假单胞菌主要分离自呼吸道标本，以收治危重症患者的科室分布较多；对多种抗菌药物具有较高的耐药性，且有上升趋势，临床应加强监控。

Objective To analyze the distribution and antimicrobial resistance of Pseudomonasaeruginosa（P. aeruginosa）in a county-level hospital,provide reference for rational antimicrobial use,and promote the control and prevention of healthcare-associated infection （HAI）.Methods Data of P.aeruginosaisolated from patients in a hospital between 2010 and 2012 were analyzed statistically.Results A total of 369 P.aeruginosaisolates were iso-lated,strains were mainly from specimens of sputum（n= 234,63.41% ）,urine（n= 41,11.11% ）and wound（n= 28, 7.59% ）;most strains were from intensive care unit（n= 146,39.56% ）,respiratory diseases department（n= 51, 13.82% ）and neurosurgical department（n= 37,10.03% ）.P.aeruginosastrains were not resistant to polymyxin B;the resistance rates to imipenem,meropenem,cefoperazone/sulbactam,piperacillin/tazobactam and amikacin were all low（6.81% -22.73% ）;from 2010 to 2012,resistance rates to antimicrobial agents （except polymyxin B） increased with varying degrees,some antimicrobial agents showed statistical difference（P〈0.05）.Conclusion P. aeruginosais mainly isolated from respiratory specimens,mainly distributed in departments with serious patients;and resistance to most antimicrobial agents is high,resistance tendency is increasing,surveillance should be intensi-fied.