某院2017~2019年铜绿假单胞菌分布及耐药性分析

Distribution and Drug-Resistance of Pseudomonas Aeruginosa in one Hospital from 2017 to 2019

目的:研究某院2017~2019年铜绿假单胞菌在临床科室的分布情况及耐药性,为临床抗感染治疗合理用药提供参考和依据。方法:采用法国梅里埃ATB系统进行细菌鉴定及药敏试验,根据CLSI 2016年标准判断药敏结果,用WHONET 5.6软件进行数据分析。结果:共分离铜绿假单胞菌1433株,其中以呼吸道标本为主(61.3%),其次为分泌物(25.9%)、中段尿(4.0%)。病区来源最高为重症监护病房(ICU,16.1%),其次为呼吸内科(14.2%)和神经外科(14.2%)。铜绿假单胞菌对哌拉西林他唑巴坦、头孢他啶耐药率呈逐年下降趋势,对喹诺酮类、黏菌素、氨基糖苷类、碳青霉烯类均保持较高的敏感性,敏感率均在60%以上。结论:ICU、呼吸内科和神经外科是铜绿假单胞菌感染的主要科室,可以采用头孢他啶、哌拉西林他唑巴坦钠、碳青霉烯类、头孢吡肟与氨基糖苷类或喹诺酮类抗菌药物联合使用方案治疗铜绿假单胞菌感染,避免或减少细菌耐药产生。

Objective:To study the distribution and drug-resistance of Pseudomonas aeruginosa in our hospital from 2017 to 2019,provide reference and basis for the rational use of anti-infective treatment.Methods:The bacterial identification and drug susceptibility test was conducted using the French Merrier ATB system.The data were analyzed using the WHONET 5.6 software according to CLSI 2016 breakpoints.Results:A total of 1433 Pseudomonas aeruginosa were isolated,which were mainly obtained from respiratory specimens,accounting for 61.3%,followed by secretions(25.9%)and urine(4.0%).The distribution of departments was mainly ICU(16.1%),followed by respiratory departments(14.2%)and neurosurgery(14.2%).The resistance rate of Pseudomonas aeruginosa to piperacillin-tazobactam and ceftazidime decreased year by year.High sensitivity to quinolones,colistin,aminoglycosides,and carbapenems were maintained,all above 60%.Conclusion:The isolates of Pseudomonas aeruginosa are mainly found in ICU,respiratory medicine department and neurosurgery department.It is necessary to combine ceftazidime,piperacillin/sulbactam,carbapenems and cefepime with aminoglycoside or quinolone antibiotics for the treatment of Pseudomonas aeruginosa infection,which will reduce drug resistance.