连续5年2279株铜绿假单胞菌的临床分布及耐药性分析

Clinical distribution and drug resistance analysis of 2279 strains of Pseudomonas aeruginosa strains during 5 consecutive years

目的了解该院近5年铜绿假单胞菌(PA)的临床分布及药敏变化情况,为临床合理选用抗菌药物和医院内感染监控提供参考依据。方法回顾性分析该院2014-2018年分离的PA感染患者的临床资料及药敏试验结果,用WHONET5.6软件进行数据统计分析。结果5年共分离到2279株PA,其总体分离株数呈上升趋势;主要分离自呼吸道和伤口分泌物;PA连续5年对监测的12种抗菌药物的耐药率均保持在20%以下,其中耐药率最低的是多黏菌素,其次为阿米卡星、庆大霉素和哌拉西林/他唑巴坦;碳青霉烯类耐药菌株的检出率逐年增多,呼吸道标本来源的PA耐药率高于其他标本。结论5年中PA分离菌株数呈增长趋势,12种抗菌药物耐药率总体保持在较低水平,但碳青霉烯类耐药菌株的检出率逐年增加,希望临床能密切关注药敏试验监测情况,合理选用抗菌药物,尤其要加强碳青霉烯类药物的合理使用。

Objective To understand the clinical distribution and drug sensitivity change situation of Pseudomonas aeruginosa(PA)in this hospital during the past five years to provide a reference for clinical rational selection of antibiotics and hospital infection surveillance.Methods The clinical data and drug sensitivity test results of the patients with PA infection isolated from the hospital during 2014-2018 were retrospectively analyzed,and the data were statistically analyzed by using WHONET5.6 software.Results A total of2 279 strains of PA were isolated during 5 years,and the total isolation rate was decreased,but the number of total isolated strains showed the increasing trend.The samples were mainly from the respiratory tract and wound secretion.The drug resistance rate of PA to the 12 kinds of antibiotics monitored for 5 consecutive years was kept below 20%,among which polymyxin was the lowest,followed by amikacin,gentamicin and piperacillin/tazobactam.The detection rate of carbapenems resistant strains increased year by year,and the PA resistance rate from respiratory tract samples was higher than that from other samples.Conclusion The number of PA isolated strains during the past 5 years showed a growing trend,and the drug resistance rate of 12 kinds of antibiotics was generally kept at a low level.However,the detection rate of carbapenems resistant strains increased year by year.It is hoped that clinic should pay close attention to the monitoring of drug sensitivity,rationally select the antibiotics,especially strengthen the rational use of carbapenems.