临床分离铜绿假单胞菌耐药性分析与监控管理

Clinical isolates of Pseudomonas aeruginosa resistance analysis and monitoring management

目的回顾性分析临床分离的418株铜绿假单胞菌,观察其科室分布及耐药性特征,并对多重耐药铜绿假单胞菌采取有效控制措施。方法采用法国Vitek 2 compact全自动微生物鉴定及药敏分析系统进行鉴定与药敏试验,参照CLSI 2012版标准判读结果,数据分析采用WHONE 5.6软件。结果418株铜绿假单胞菌主要来源于呼吸内科、重症监护病房、神经外科;标本以呼吸道痰液为主占78.72%;阿米卡星耐药率最低为4.79%,其次为头孢吡肟和头孢他啶,分别为25.36%和29.19%,其余抗菌药物耐药率均超过30%,其中氨曲南耐药率最高为50.72%。结论铜绿假单胞菌分离主要来自下呼吸道标本,其耐药性较高。临床应重视药敏试验并合理使用抗菌药物,同时加强铜绿假单胞菌的监控与感染管理。

Objective To retrospectively analyze 418 clinical isolates of Pseudomonas aeruginosa,observe the department distribution and drug resistance characteristics,and take effective control for multi-drug resistant P.aeruginosa.Methods Vitek 2 compact automated microbial identification and susceptibility for identification and susceptibility testing were used.Data were analyzed according to CLSI 2012 breakpoints with WHONET 5.6 sofeware.Results418 isolates of P.aeruginosa were mainly from the respiratory medicine department,ICU and neurosurgery department.The samples from the sputum of respiratory tract were predominant,representing 78.72%.The drug resistance of P.aeruginosa to Amikacin was the lowest as 4.79%,followed by Cefepime and Ceftazidime,respectively,25.36%and 29.19%,and the rest of antimicrobial drug resistance rate over 30%,of which the highest Aztreonam was 50.72%.Conclusion P.aeruginosa is mainly from respiratory tract specimens higher resistance.Antimicrobial resistance surveillance plays an important role in controlling hospital infection.The monitoring and management measures should be strengthened.