北京市某医院354株铜绿假单胞菌分布及耐药情况分析

Distribution and drug resistance of 354 isolates of Pseudomonas aeruginosa in a hospital of Beijing

目的通过分析铜绿假单胞菌来源及其在不同年龄人群中的耐药趋势,为临床抗感染治疗提供依据。方法对2017年6月—2018年2月分离自3 726例临床样本的细菌进行菌种鉴定及药物敏感性分析,并分析铜绿假单细胞菌在≤14岁、15~60岁、>60岁人群中的耐药情况。结果共检出354株铜绿假单胞菌,分离率为9.5%。样本类型以痰液(59.9%)、引流液(13.3%)、尿液(10.7%)、咽拭子(6.2%)、血液(5.1%)和分泌物(1.4%)为主。检出率较高的临床科室分别为重症监护病房(ICU,19.4%)、急诊科(18.4%)及呼吸内科(12.7%)。分离自≤14岁人群的铜绿假单胞菌对阿米卡星、头孢吡肟以及妥布霉素均敏感,分离自15~60岁和>60岁人群的铜绿假单胞菌相关抗菌药物耐药率相近,对阿米卡星的耐药率最低,分别为8.8%和11.7%,其次为妥布霉素、庆大霉素、头孢吡肟。结论铜绿假单胞菌样本来源较集中,对阿米卡星、妥布霉素的耐药率较低,临床应根据药物敏感性试验结果合理选用抗菌药物。

Objective To analyze the source of Pseudomonas aeruginosa and the drug resistance status for different ages,and to provide a reference for clinical anti-infection treatment. Methods Identification and drug susceptibility analysis for 3 726 clinically isolated bacteria from June 2017 to February 2018 were performed. The patients for the 3 726 clinically isolated bacteria were classified into ≤14-year-old,15-60-year-old and >60-year-old groups. Results A total of 354 isolates of Pseudomonas aeruginosa were isolated from the 3 726 clinical specimens,and the isolation rate was 9.5%. The main types of clinical specimens were sputum(59.9%),drainage fluid(13.3%),urine(10.7%),throat swab(6.2%),blood(5.1%) and secreta(1.4%). The departments with high isolation rates were intensive care unit(ICU)(19.4%),emergency(18.4%) and respiratory medicine(12.7%). Pseudomonas aeruginosa isolated from ≤14-year-old group were sensitive to amikacin,cefepime and tobramycin. The drug resistance rates of 15-60-year-old and >60-year-old groups were similar,and the drug resistance rates to amikacin were the lowest(8.8% and 11.7%,respectively),followed by tobramycin,gentamicin and cefepime. Conclusions Pseudomonas aeruginosa are isolated from sputum mainly. The drug resistance rates to amikacin and tobramycin are low. Clinic should choose rational antibiotics according to the results of drug susceptibility analysis.