2013—2018年慢性阻塞性肺疾病住院患者黏液型与非黏液型铜绿假单胞菌耐药性分析

Drug resistance analysis of mucinous and non mucinous Pseudomonas aeruginosa isolated from hospitalized patients with COPD from 2013 to 2018

目的分析2013—2018年慢性阻塞性肺疾病(COPD)住院患者黏液型与非黏液型铜绿假单胞菌(PA)耐药性,为临床控制PA感染提供参考。方法收集青岛大学附属医院药学部2013—2018年临床分PA的病原学资料,回顾性分析其对常用抗菌药物的耐药性情况。结果共分离出黏液型PA 489株,非黏液型PA 446株。黏液型PA对常用抗菌药物的敏感性高于非黏液型,2种类型的PA对喹诺酮类药物左氧氟沙星和环丙沙星的敏感率只有40%左右,黏液型PA对阿米卡星、庆大霉素、氨曲南、美罗培南、多黏菌素E、哌拉西林他唑巴坦保持在80%以上的敏感性;非黏液型PA仅对阿米卡星、庆大霉素、多黏菌素E保持在80%以上的敏感性。结论黏液型与非黏液型PA耐药率差异较大,临床治疗应参考药敏,对于黏液型PA应增加剂量或联用对生物膜有清除作用的药物。

Objective To analyze the drug resistance of mucinous and non mucinous Pseudomonas aeruginosa(PA)in hospitalized patients with chronic obstructive pulmonary disease(COPD)from 2013 to 2018,so as to provide reference for clinical control of PA infection.Methods To collect the pathogenic data of PA isolated from patients with COPD from January 2013 to December 2018,and to retrospectively analyze their resistance to commonly used antibiotics.Results A mucus type PA 489 strains and a non-mucus PA 446 strains were isolated.Mucus PA were more sensitive to common antibacterial drugs than non-mucus type.The sensitivity of two types of PA to quinolones such as levofloxacin and ciprofloxacin were only about 40%.Mucus-type PA maintains sensitivity to more than 80%for amikacin,gentamicin,aztreonam,meropenem,polymyxin E,and piperacillin tazobactam;non-mucus PA only maintains sensitivity to more than 80%for amikacin,gentamicin,and polymyxin E.Conclusion There is a big difference in the drug resistance rate between mucus and non-mucus PA.For clinical treatment,reference should be made to drug sensitivity.For mucus type PA,the dose should be increased or the drug that has a scavenging effect on biofilm should be used.