2010—2013年重庆地区儿童感染铜绿假单胞菌的临床分布及耐药性分析

Distribution and antibiotic resistance of Pseudomonas aeruginosa isolates from children in Chongqing from 2010 to 2013

目的了解重庆地区儿童2010—2013年铜绿假单胞菌的临床分布特征及耐药性,为合理应用抗菌药物和预防控制医院感染提供依据。方法分析2010—2013年检出的1920株铜绿假单胞菌对11种抗菌药物的耐药性,采用BD Phoenix 100MIC法结合K-B纸片扩散法进行药敏试验,按美国临床实验室标准化委员会(CLSI)标准判断结果。结果共分离铜绿假单胞菌1920株,检出率为3.6%;以痰标本多见,占69.1%(1327株);铜绿假单胞菌对多黏菌素的耐药率最低,仅为4.0%,对哌拉西林,莫西沙星的耐药率分别为37.7%,42.2%。2010—2013年铜绿假单胞菌对哌拉西林/三唑巴坦、亚胺培南、美罗培南、莫西沙星、庆大霉素的耐药率无明显改变(P>0.05),其余受试药物的耐药率均有明显改变(P<0.05)。共检出多重耐药铜绿假单胞菌(MDRPA)334株,占17.4%,泛耐药铜绿假单胞菌(PDRPA)13株,占0.7%,铜绿假单胞菌在呼吸科的检出率明显高于其他病区(P<0.05)。结论铜绿假单胞菌的耐药性呈上升趋势,呼吸病房是预防控制的重点科室。

Objective To investigate the distribution and antibiotic resistance of Pseudomonas aeruginosa isolated from Chongqing＇s children during the period of Jan 2010 to Dec 2013 and provide the reference for reasona ble use of antibiotics and prevention and control of nosoeomial infections. Methods Identifications and antibiotic susceptibility tests （AST） of the total 1920 Pseudomonas aeruginosa isolates were performed by BD Phoenix 100 automated system and the conventional Kirby-Bauer method. The AST results were interpreted according to the guidelines of the Clinical and Laboratory Standards Institute （CLSI）. Results Atotal of 1920 Pseudomonas aeruginosa were isolated, accounting for 3.6%. The maximum number of Pseudomonas aeruginosa（1327 strains） was isolated from sputum （69.1%）. The susceptibility of Pseudomonas aeruginosa strains were determined as 4.0% for polymyxin, 37.7% for piperacillin, 42.2% for moxifloxacin. There was no significant change（P〉0.05） of nonsusceptibility rates among piperacillin/tazobactam, imipenem, meropenem, moxifloxacin, gentamycinin isolates during the investigation period. However, the difference of resistancerates of the rest antibiotics were considered statistically significant（P〈0.05）. Atotal of 334 isolates（17.4%） multiple drug resistant Pseudomonas aeruginosa（MDRPA） and 13 isolates（0.7%） pandrug-resistant Pseudomonas aeruginosa（PDRPA） were collected. The detection rates of the Pseudomonas aeruginosa in pneumology department were significantly higher than in other wards（P〈0.05）. Conclusion Pseudomonas aeruginosa isolates trend towards higher rates of drug resistance. It is necessary to focus on the prevention and control of the nosocomial infections in the pneumology department.