河南144所医院2019~2020年恶臭假单胞菌感染临床特点及药敏分析

Clinical Characteristics and Susceptibility Analysis of Pseudomonas putida Infection in 144 Henan Hospitals During 2019 and 2020

目的:分析河南省144所医院恶臭假单胞菌感染现状、临床特点及耐药性情况,并比较不同级别医院细菌耐药性差异,为院内感染控制及临床治疗提供参考。方法:收集2019年1月~2020年12月期间河南省144所医院上报的470例恶臭假单胞菌感染患者数据,分析标本来源、科室分布、药敏情况、不同级别医院细菌耐药性差异。结果:恶臭假单胞菌感染以男性、老年患者居多;标本来源以非呼吸道标本占比高(247株,52.6%);科室分布以重症医学科(98株,20.9%)、骨科(60株,12.8%)和呼吸内科(40株,8.5%)为主。药敏试验结果显示,恶臭假单胞菌对多黏菌素B、庆大霉素的耐药率较低,其余药物的耐药率均>30%;三级医院氨苄西林/舒巴坦、氯霉素、复方磺胺甲唑、美罗培南、氨曲南的耐药率均高于二级医院(P<0.05)。结论:该地区恶臭假单胞菌感染多见于老年、男性、重症患者,恶臭假单胞菌对多种药物耐药率较高,对多黏菌素B敏感性好,且三级医院多种药物的耐药率均高于二级医院。临床需重点关注高危患者,加强合理用药及医院感染控制。

Objective:To analyze the current infection status,clinical characteristics and drug resistance of Pseudomonas putida in 144 hospitals in Henan province,and to compare the differences in bacterial resistance across different levels of hospitals,so as to provide reference for nosocomial infection control and clinical treatment.Methods:The data of 470 patients infected with Pseudomonas putida reported by 144 hospitals in Henan province from January 2019 to December 2020 were collected to analyze specimen sources,distribution of departments,drug susceptibility and the difference in bacterial resistance across different levels of hospitals.Results:Male and elderly patients were the predominant population infected with Pseudomonas putida.Non-respiratory specimens accounted for a high proportion(247 strains,52.6%).The infection was mainly distributed in departments of critical care medicine(98 strains,20.9%),orthopedics(60 strains,12.8%)and respiratory medicine(40 strains,8.5%).The results of susceptibility test showed that the resistance rates of Pseudomonas putida against polymyxin B and gentamicin were lower,and the drug resistance rate of other drugs was more than 30%.The resistance rates against ampicillin/sulbactam,chloramphenicol,cotrimoxazole,meropenem and aztreonam in tertiary hospitals were higher than those in secondary hospitals(P<0.05).Conclusion:Pseudomonas putida infection was more frequently observed in elderly,male and critically ill patients in this region.The bacterium showed a high resistance rate against multiple drugs and a good susceptibility to polymyxin B,and the multi-drug resistance rate was higher in tertiary hospitals than in secondary hospitals.It is necessary to pay more attention to high-risk patients and strengthen rational drug use and control of nosocomial infection.