云南省三甲医院3411株铜绿假单胞菌的耐药分析

Analysis on Drug Resistance of 3,411 Strains of Pseudomonas Aeruginosa in Third-class A Hospital of Yunnan Province

目的 :分析我院铜绿假单胞菌的临床分布及耐药性,为临床合理使用抗菌药提供指导。方法 :选取我院2014年7月—2017年7月各临床科室就诊的住院和门诊患者所送检标本中分离的铜绿假单胞菌作为研究对象,分析该菌的耐药性。结果 :分离出的3 411株铜绿假单胞菌中有49.43%来自呼吸道标本,主要分布于整形烧伤科和ICU,所占比例分别为19.61%、18.21%;分离出的铜绿假单胞菌对氨苄西林耐药率为100%,对阿莫西林/克拉维酸、头孢曲松、头孢呋辛、头孢噻肟、头孢西丁、复方磺胺甲恶唑分别达到97%以上;来源于血液标本中的铜绿假单胞菌对哌拉西林、哌拉西林/他唑巴坦、头孢他啶、亚胺培南、美罗培南、阿米卡星、庆大霉素、环丙沙星、左氧氟沙星的耐药率均高于来源痰液标本中的铜绿假单胞菌,差异有统计学意义(P <0.05)。结论 :2014年7月—2017年7月我院分离出的3 411株铜绿假单胞菌中大部分来自整形烧伤外科和ICU,血液中分离出的铜绿假单胞菌对多数抗菌药物的耐药率均高于痰液中的耐药率。

Objective:To analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa in our hospital to provide guidance for the clinically rational use of antimicrobials.Methods:Pseudomonas aeruginosa strains isolated from the inpatients and outpatients of the Department of Clinical Laboratory in our hospital from July 2014 to July 2017 were selected as subjects investigated,and their drug resistance was analyzed.Results:49.43%of the isolated 3,411 strains of Pseudomonas aeruginosa were from respiratory specimens,mainly distributed in the Department of Plastic Burn and ICU,accounting for 19.61%and 18.21%,respectively.The resistance rate of isolated Pseudomonas aeruginosa to ampicillin was 100%,and the resistance rates to amoxicillin/clavulanic acid,ceftriaxone,cefuroxime,cefotaxime,cefoxitin and compound sulfamethoxazole were more than 97%.The resistance rates of Pseudomonas aeruginosa from blood samples to piperacillin,piperacillin/tazobactam,ceftazidime,imipenem,meropenem,amikacin,gentamicin,ciprofloxacin and levofloxacin were higher than those from sputum samples,and the differences were statistically significant(P<0.05).Conclusion:Most of the 3,411 Pseudomonas aeruginosa strains isolated in our hospital from July 2014 to July 2017 were from the Department of Plastic Burn Surgery and ICU,and the resistance rate of Pseudomonas aeruginosa number isolated from blood to most antimicrobials was higher than that from sputum.