医院大肠埃希菌和铜绿假单胞菌的分布及耐药性分析

Antibiotic resistance and distribution of Escherichia coli and Pseudomonas aeruginosain a hospital

目的分析我院2012~2015年住院患者大肠埃希菌和铜绿假单胞菌的临床分布及耐药性,为临床合理用药提供依据。方法对2012~2015年的临床标本按常规进行病原菌分离,采用VITEK2全自动细菌鉴定与药敏分析仪对大肠埃希菌和铜绿假单胞菌进行鉴定。结果共分离出大肠埃希菌3 210株,其中产超广谱β-内酰胺酶(ESBLs)菌株1 916株,占59.69%,主要来源于尿液(45.95%),感染科室主要分布于普外科(30.21%)和重症医学科(26.54%)。铜绿假单胞菌2 585株,其中多药耐药菌株311株,占12.03%,主要来源于痰液84.09%,感染科室主要分布于呼吸内科(44.56%)和重症医学科(23.07%);大肠埃希菌对美罗培南、亚胺培南、头孢替坦、哌拉西林/他唑巴坦和厄他培南的耐药率较低(≤5%),对氨苄西林、哌拉西林和头孢唑啉的耐药率较高(≥50%);铜绿假单胞菌对阿米卡星和头孢吡肟耐药率较低(≤10%)。结论我院住院患者大肠埃希菌和铜绿假单胞菌感染分布较广,对常见抗菌药物呈现不同程度的耐药性。医院加强对病原菌的耐药性监测,对指导临床合理使用抗菌药物及减缓多药耐药菌株的形成具有重要意义。

Objective To investigate the antibiotic resistance and distribution of Escherichia coli and Pseudomonas aeruginosain our hospital,and to provide a basis of rational use of antibiotics in the clinical departments.Methods The specimens of nosocominal infections were isolated routinely from 2012 to 2015,and the bacteria identification and susceptibility test were performed.Results3 210 strains of Escherichia coli were isolated,including 1 916 strains of ESBLs-product,accounting for 59.69%,mainly derived from urine（45.95%）.The infection departments were general surgery（30.21%）and ICU（26.54%）.2 585 strains of Pseudomonas aeruginosa were isolated,including 311 strains of MDR,accounting for 12.03%,mainly from sputum（84.09%）.The main infection departments were ICU（26.54%）and the department of respiratory medicine.The drug resistance rates of Escherichia coli to meropenem,imipenem,cephalosporins cefotetan,piperacillin and tazobactam,and ertapenem were≤5%,while to ampicillin,piperacillin,cefazolin were≥50%.The resistance rate of Pseudomonas aeruginosa to amikacin and cefepime was low（less than10%）.Conclusion The Escherichia coli and Pseudomonas aeruginosainfections were widely distributed in our hospital inpatients,and the infections showed different degrees of resistance to common antibiotics.It is of great significance to strengthen the monitoring of drug resistance of pathogenic bacteria,guide the clinical rational use of antimicrobial drugs and reduce multidrug resistant strains.