2013-2015年临床分离铜绿假单胞菌耐药性及Ⅰ类整合子变化分析

Analysis on changes of drug resistance and classⅠintegron in clinically isolated Pseudomonas aeruginosa during 2013-2015

目的检测该院2013年1月至2015年12月临床分离铜绿假单胞菌耐药性及Ⅰ类整合子变化。方法对2013-2015年临床分离的铜绿假单胞菌分为2013年、2014年和2015年3个时间阶段,采用法国生物梅里埃公司的VITEK-2Compact研究其对22种常用抗菌药物的耐药性;在3个时间段分离的菌株中分别随机选取100株,采用PCR扩增检测Ⅰ类整合子。结果3个时间段分别检出铜绿假单胞菌为366、437和520株。铜绿假单胞菌对22种常用抗菌药物耐药性增长明显(P<0.05),以重症监护病房(ICU)最为显著。Ⅰ类整合子阳性菌检出率逐年增加,且Ⅰ类整合子阳性菌耐药性明显高于阴性菌(P<0.01)。结论该院铜绿假单胞菌耐药性较高,Ⅰ类整合子和多重耐药检测比例增加明显。需要加强医院感染的检测和耐药菌监控,进一步规范抗菌药物使用。

Objective To investigate the changes of drug resistance and class Ⅰ integron in clinically isolated Pseudomonas aeruginosa（PA）in our hospital form January 2013 to December 2015.Methods Clinically isolated PA strains were divided into the3 time periods of 2013,2014 and 2015.Their resistance to 22 commonly used antibacterial drugs was investigated by adopting the VITEK-2;200strains were randomly selected from the isolated strains during these 3time periods.ClassⅠintegron was detect by PCR.Results The detected PA in these 3time periods had 366,437 and 520strains respectively.The drug resistance of Pseudomonas aeruginosa to 22 commonly used antibacterial drugs was remarkably increased（P〈0.05）,especially in ICU.The detection rate of classⅠintegron positive bacteria was gradually increased year by year,moreover the drug resistance rate of classⅠintegron positive bacteria was significantly higher than that of classⅠintegron negative bacteria（P〈0.01）.Conclusion The drug resistance rate of PA in this hospital is higher.The proportions of multi-drug resistance and classⅠ integron are significantly increased.The hospital infection detection and drug-resistant bacterial monitoring should be strengthened to further standardize the use of antibacterial drugs.