住院患者肺部感染铜绿假单胞菌的耐药性变迁分析

Drug resistance change of Pseudomonas aeruginosa causing pulmonary infections in inpatients

目的探讨金华地区多所医院住院患者肺部感染铜绿假单胞菌的耐药性变化,为临床治疗铜绿假单胞菌所致肺部感染提供参考依据。方法选取2011-2013年金华地区多所医院肺部感染患者分别为2 090、1 611、1 341例,采集其痰液进行细菌培养,分离获得铜绿假单胞菌,并通过K-B纸片扩散法对检出的菌株进行耐药性测定,数据采用SPSS 13.0软件进行统计分析。结果 2011-2013年住院患者肺部感染分别检出1 944、1 492及1 244株病原菌,检出率分别为93.01%、92.61%和92.77%,差异无统计学意义;其中铜绿假单胞菌分别检出311、284、262株,检出率分别为16.00%、19.03%和21.06%,铜绿假单胞菌所占比例逐年升高,差异有统计学意义(P<0.05);铜绿假单胞菌对哌拉西林、头孢吡肟的耐药性2011年最高,2012年稍有降低,2013年再次升高。结论近3年来金华地区多所医院住院患者肺部感染铜绿假单胞菌在所有病原菌中所占比例逐渐升高,对曾经敏感的抗菌药物耐药性也逐年升高,给治疗带来困难;哌拉西林/他唑巴坦仍然是耐药性最低的抗菌药物。

OBJECTIVE To investigate drug resistance char, ge of Pseudomonas aeruginosa causing pulmonary infections in inpatients in Jinhua area so as to provide references for clinical treatments. METHODS From 2011 to 2013, 2090, 1611 and 1341 cases of patients with lung infections from three hospitals in Jinhua area were selected. Their sputum samples were collected to conduct bacterial culture and isolate P. aeruginosa. K-B disk diffusion was adopted to detect the isolated strains. SPSS 13.0 was adopted for statistical analysis. RESULTS Totally 1944, 1492 and 1244 strains of pathogens were detected from those inpatients and the pathogen detection rates were 93.01%, 92.61% and 92.77%. The differences were not significant. Among them, 311,284,262 strains of P. aeruginosa were detected, and the detection rates were 16.00%, 19.03% and 21.06%. The proportion of P. aeruginosa signifieatly increased year by year （P〈0.05）. The drug resistance of P. aeruginosa to piperacillin and cefepime in 2011 was the highest while decreased in 2012 and increased again in 2013. CONCLUSION Over the past three years, the proportion of patients with P. aeruginosa caused pulmonary infections increased gradually. The drug resistances of them to antibiotics used to be effectively increased year by year, making it difficult to treat the infections. However, piperaeillin/tazobactam are still the best antibiotics with the lowest drug resistance.