医院铜绿假单胞菌分布及耐药性分析

Distribution and Drug Resistance Analysis of Pseudomonas Aeruginosa in Hospitals

探讨医院铜绿假单胞菌分布及耐药性。方法:选取2014年1月-2019年1月陇东学院附属医院住院患者的各种病原菌培养标本5286份,对所有标本进行培养、鉴定、药敏试验,分析铜绿假单胞菌分布和耐药性。分析病原菌分离情况、医院铜绿假单胞菌分布情况、不同科室铜绿假单胞菌分布情况、铜绿假单胞菌对常用的抗菌药物耐药情况。结果:5286份标本中,共分离出铜绿假单胞菌1064株,分离阳性率为20.1%;1064株铜绿假单胞菌中,标本主要为痰液(71.0%)、创伤分泌物(10.2%)、中段尿(6.2%)、胸腹腔积液(5.5%),其他的标本分布比较少;1064株铜绿假单胞菌中,主要分布在呼吸内科(19.6%)、ICU(13.3%)、老年病科(13.0%)、泌尿外科(5.9%),其他的科室分布比较少;耐药性较高的药物主要有头孢噻肟(58.5%)、环丙沙星(50.0%)、庆大霉素(50.8%)、复方新诺明(84.8%);敏感度较高的药物主要有阿米卡星(30.5%)、头孢他啶(32.2%)、哌拉西林/他唑巴坦(35.6%)、头孢哌酮/舒巴坦(13.5%)、亚胺培南(11.8%)。结论:医院铜绿假单胞菌引发的临床感染明显增多,临床检出率明显提高,但是随着药物的耐药性提高,临床上应该加强药物的耐药性监测,合理使用抗菌药物,以便降低细菌的耐药性。

Objective:to investigate the distribution and drug resistance of pseudomonas aeruginosa in hospital.Methods:A total of 5,286 specimens of various pathogenic bacteria were collected from hospitalized patients in our hospital from January 2017 to January 2018.All specimens were cultured,identified,and tested for drug sensitivity,and the distribution and drug resistance of Pseudomonas aeruginosa were analyzed.Analysis of pathogen isolation,distribution of Pseudomonas aeruginosa in hospitals,distribution of Pseudomonas aeruginosa in different departments,and resistance of P.aeruginosa to commonly used antibiotics.Results:1064 strains of pseudomonas aeruginosa were isolated from 5286 samples,with a positive rate of 20.1%.Among 1064 strains of pseudomonas aeruginosa,the specimens were mainly sputum(71.0%),traumatic secretion(10.2%),midsection urine(6.2%),and pleural effusion(5.5%),while other specimens were less distributed.The 1064 strains of pseudomonas aeruginosa were mainly distributed in respiratory department(19.6%),ICU(13.3%),geriatrics department(13.0%)and urology department(5.9%).The drugs with higher drug resistance mainly include cefotaxime(58.5%),ciprofloxacin(50.0%),gentamicin(50.8%)and compound xinnomin(84.8%).The most sensitive drugs were amikacin(30.5%),ceftazidine(32.2%),piperacillin/tazobactam(35.6%),cefoperazone/sulbactam(13.5%)and imipenem(11.8%).Conclusion:clinical infection caused by pseudomonas aeruginosa in hospital is significantly increased and the clinical detection rate is obviously improved.However,with the increase of drug resistance,drug resistance monitoring should be strengthened in clinical practice,and antimicrobial agents should be used reasonably so as to reduce bacterial resistance.