呼吸科下呼吸道感染铜绿假单胞菌耐药性变迁

Evolution of Drug-resistance of Pseudomonas Aeruginosa of Lower Respiratory Infection in the Department of Respiration

目的探讨医院呼吸科下呼吸道感染住院患者2011—2016年铜绿假单胞菌耐药性变迁趋势,指导临床抗菌药物使用。方法调查广西南宁市某三甲医院呼吸科2011年1月—2016年12月收治的4 126例下呼吸道感染住院患者呼吸道分泌物培养结果,回顾性分析其中129例铜绿假单胞菌对常用抗菌药物耐药率变化。结果医院呼吸科下呼吸道感染患者铜绿假单胞菌对常用抗菌药物体外呈高耐药性,除复方新诺明外,6年耐药率总体呈上升趋势。除头胞哌酮/舒巴坦外,2016年对头孢他定、哌拉西林/他唑巴坦、环丙沙星、左氧氟沙星耐药率均在50.0%以上,2016年对亚胺培南耐药率为54.8%,美罗培南为48.4%。结论医院呼吸内科下呼吸道感染患者铜绿假单胞菌耐药形势严峻,对包括碳青霉烯类在内等多种具有抗假单胞菌活性抗菌素均呈高耐药性,临床应重视抗生素合理用药。

Objective To study the evolution trend of drug-resistance of pseudomonas aeruginosa of lower respiratory infection of inpatients in the department of respiration and guide the use of clinical antibacterial drugs. Methods The culture results of respiratory secretions of 4 126 cases of inpatients in the department of respiration in our hospital from January 2011 to December 2016 were surveyed and change of drug-resistance of 129 cases of pseudomonas aeruginosa to common antibacterial drugs were retrospectively analyzed. Results The drug-resistance of pseudomonas aeruginosa of patients with lower respiratory infection in our hospital to common antibacterial drugs was high, in addition of com- pound sulfamethoxazole, the total drug-resistance rate of six years showed an increasing trend, in addition to the cefop- erazone/sulbactam, in 2016, the drug-resistance to ceftazidime and piperacillin/tazobactam, ciprofloxacin and lev- ofloxacin was above 50.0%, in 2016, the drug-resistance to imipenem was 54.8% and meropenem was 48.4%. Conclu- sion The drug-resistance situation of pseudomonas aeruginosa of patients with lower respiratory infection in the depart- ment of respiration medicine is severe, and the drug-resistance to multiple pseudobactin such as carbapene is high, andwe should pay attention to the rational medication of an- tibiotics in clinic.