康复医院住院患者感染的铜绿假单胞菌临床分布及耐药情况研究

Research on clinical distribution and drug resistance of pseudomonas aeruginosa infected by hospitalized patients in the rehabilitation hospital

目的探讨康复医院住院患者铜绿假单胞菌(PA)的临床分布及耐药情况,为临床治疗铜绿假单胞菌感染提供参考依据。方法选取2017年广东省工伤康复医院住院患者送检的1528例标本进行细菌培养,以分离鉴定的133株铜绿假单胞菌为研究对象,并对其进行药敏试验。结果本研究检出的PA占病原微生物总数的14.29%。PA主要来自痰液、尿液、伤口分泌物,其构成比分别为48.9%、36.8%、14.3%。多重耐药铜绿假单胞菌的检出率为24.8%。PA对康复医院临床常用的16种抗生素均有不同程度的耐药,对左氧氟沙星、替卡西林、美罗培南、氨曲南具有较高的耐药性,耐药率分别为86.7%、85.7%、82.9%、80.0%,多数药物的耐药率在20%～40%。对多粘菌素E、阿米卡星、妥布霉素、头孢他定具有较高的敏感性,敏感率分别为100.0%、88.9%、87.7%、71.9%。结论康复医院铜绿假单胞菌检出率较高,耐药情况严重,医院应加强耐药检测,以便临床选择有效的抗菌药物。

Objective To explore the clinical distribution and drug resistance of pseudomonas aeruginosa(PA) in hospitalized patients in the rehabilitation hospital and to provide reference for clinical treatment of pseudomonas aeruginosa infection. Methods 1528 specimens from hospitalized patients in Guangdong Work Injury Rehabilitation Hospital in 2017 were selected. 133 strains of pseudomonas aeruginosa isolated and identified were selected as research objects, and they were given drug sensitivity test. Results The PA detected in this study accounted for 14.29% of the total number of pathogenic microorganisms. PA was mainly from sputum, urine and wound secretions, and their composition ratios were 48.9%, 36.8% and 14.3% respectively. The detection rate of multidrug-resistant pseudomonas aeruginosa was 24.8%. PA had different degrees of resistance to 16 kinds of antibiotics commonly used in the rehabilitation hospital. PA was highly resistant to levofloxacin, ticacillin, meropenem and xantrone, with drug resistance rates of 86.7%, 85.7%, 82.9% and 80.0%, respectively. The drug resistance rates of most drugs were 20% to 40%. PA was highly sensitive to colistin E, amikacin, tobramycin and cefostatin, with sensitivity rates of 100.0%, 88.9%, 87.7% and 71.9%, respectively. Conclusion The detection rate of pseudomonas aeruginosa is high in the rehabilitation hospital, and the drug resistance is serious. The hospital should strengthen drug resistance testing in order to select effective antimicrobial drugs in clinical practice.