2015-2018年某院支气管扩张症患者感染铜绿假单胞菌的药物敏感性变迁分析

Analysis on the changes in drug susceptibility of pseudomonas aeruginosa infecting patients with bronchiectasis

目的分析支气管扩张症患者感染铜绿假单胞菌(PA)的抗菌药物敏感性变迁。方法收集某医院2015年9月1日至2016年8月31日(第1阶段)、2016年9月1日至2017年8月31日(第2阶段)、2017年9月1日至2018年8月31日(第3阶段)扩张症患者感染的PA。采用琼脂稀释法检测PA对11种常用抗菌药物的敏感性。结果在第1、2、3阶段检出的黏液型PA分别占16.0%、25.0%和29.3%。第3阶段的整体PA和非黏液型PA对哌拉西林-他唑巴坦(TZP)、头孢哌酮(CFP)、头孢哌酮-舒巴坦(SCF)、头孢吡肟(FEP)、亚胺培南(IMI)、环丙沙星(CIP)的敏感性均明显高于第1阶段(P<0.05)。3年间的整体黏液型PA对TZP、CFP、SCF、FEP、IMI和CIP的敏感率亦明显高于非黏液型PA(P<0.05)。结论在支气管扩张症患者中,PA的药物敏感性逐年升高,且黏液型PA比非黏液型PA升高更明显。

Objective To investigate the changes in drug susceptibility of pseudomonas aeruginosa (PA) infecting patients with bronchiectasis. Methods PA infecting patients with bronchiectasis from September 1, 2015 to August 31, 2016 (Phase 1), September 1, 2016 to August 31, 2017 (Phase 2) and September 1, 2017 to August 31, 2018 (Phase 3) were collected. Agar dilution method was used to detect the susceptibility of PA to 11 antimicrobials commonly used. Results The mucoid PA detected in the Phase 1, 2 and 3 accounted for 16.0%, 25.0% and 29.3%, respectively. The drug susceptibility of whole PA and non-mucoid PA to TZP, CFP, SCF, FEP, IMI and CIP in Phase 3 was significantly higher than that in Phase 1 (P<0.05). The whole mucoid PA were more susceptible to TZP, CFP, SCF, CFP, IMI and CIP than non-mucoid PA during the three years (P<0.05). Conclusion In patients with bronchiectasis, the drug susceptibility of PA increases year by year, and mucoid PA shows a more significant susceptibility than non-mucoid significantly.