多重耐药铜绿假单胞菌院内感染分布及耐药性研究

Distribution and drug resistance study of multi-drug resistant Pseudomonas aeruginosa in nosocomial infection

目的探讨多重耐药铜绿假单胞菌发生院内感染的感染分布及耐药性特征。方法选取2014年1月至2015年6月期间我院收治的所有发生铜绿假单胞菌院内感染的194例患者作为研究对象,患者送检标本中共分离出217株铜绿假单胞菌,详细记录送检标本感染分布情况,做细菌药敏试验,观察并比较铜绿假单胞菌对各抗生素药物的耐药性和敏感性。结果铜绿假单胞菌在呼吸科送检标本中分布率最高,占38.25%,其次为神经科和感染科,分别为15.67%和13.36%。铜绿假单胞菌在痰液中分布较广,共检出144株,占66.36%,其次在创面分泌物和穿刺液中,分别为13.82%和8.76%。铜绿假单胞菌对亚胺培南的耐药率最低,仅占7.83%,对头孢噻肟耐药率最高,占48.39%。铜绿假单胞菌对亚胺培南敏感率最高,约91.91%,对头孢噻肟敏感率最低,仅9.68%。结论多重耐药铜绿假单胞菌引起的院内感染多为呼吸系统感染疾病,且对多种药物耐药率较高,敏感性低,临床治疗难度加大,治疗时要根据药敏试验结果合理选择抗生素治疗,提高药物疗效。

Objective To explore the distribution and drug resistance of multi-drug resistant Pseudomonas aeruginosa in nosocomial infection. Methods A total of 194 patients with nosocomial infection caused by Pseudomonas aeruginosa in our hospital from January 2014 to June 2015 were selected as the research objects, from which 217 strains of Pseudomonas aeruginosa were isolated. The infection distribution of the samples were recorded in detail,and bacterial susceptibility testing was performed for the drug resistance and sensitivity of Pseudomonas aeruginosa to antibiotics. Results Pseudomonas aeruginosa strains were mostly distributed in samples of the Department of Respiration(accounting for 38.25%), followed by Department of Neurology(15.67%) and Infectious Diseases(13.36%).Pseudomonas aeruginosa was widespread in sputum, with 144 strains detected(accounting for 66.36%), followed by the puncture wound secretions(13.82%) and punctate(8.76%). Pseudomonas aeruginosa had lowest resistance of 7.83% to imipenem and the highest resistance of 48.39% to cefotaxime, and they had the highest sensitivity of about 91.91% to imipenem and the lowest sensitivity of only 9.68% to cefotaxime. Conclusion Nosocomial infection caused by multi-drug resistant Pseudomonas aeruginosa is mostly respiratory infection disease, and the clinical treatment is difficult due to high drug resistance and low sensitivity. Thus, we should improve drug efficacy based on rational use of antibiotic therapy according to the results of drug sensitivity test.