摘要
目的了解医院2008-2011年铜绿假单胞菌分布及耐药性变迁,为临床合理用药提供参考。方法回顾性分析2008-2011年医院各类临床标本所分离的铜绿假单胞菌分布及药敏结果。结果医院2008-2011年共分离出铜绿假单胞菌420株,分离率4.44%;标本来源以痰液为主,占79.00%,其次是分泌物,占7.85%;科室分布以神经外科最多,占22.38%,其次是呼吸内科和ICU,分别占20.95%和20.00%;铜绿假单胞菌的耐药性整体呈逐年上升趋势,耐药情况严重,除对亚胺培南耐药率较低外,对其他抗菌药物均产生了较严重的耐药性;对亚胺培南、美罗培南、头孢哌酮/舒巴坦、头孢他啶、阿米卡星、左氧氟沙星耐药率相对低,到2011年耐药率在37.06%～49.24%;对磺胺甲噁唑/甲氧苄啶、阿莫西林/克拉维酸、氨苄西林、庆大霉素、头孢西丁及除头孢他啶外的头孢菌素,均呈较高的耐药性,至2011年耐药性接近100.00%;氨曲南、头孢哌酮/舒巴坦,在2008年时耐药率低,分别为16.67%和17.24%,但从2009年开始耐药率逐年上升,至2011年耐药率分别为54.05%和42.35%;亚胺培南和美罗培南在2008年时耐药率低,分别为26.42%、28.3%,但从2009年开始逐年上升,至2011年耐药率分别为37.24%和45.18%。结论铜绿假单胞菌的分离率和耐药性呈逐年上升趋势,多药耐药和泛耐药情况严重,应加强抗菌药物分级管理,临床科室应依据药敏结果合理应用抗菌药物,同时做好重点科室的医院感染控制,防止耐药菌株播散。
OBJECTIVE To investigate the characteristics of distribution and the change of drug resistance of Pseud- omonas aeruginosa isolated from 2008 to 2011 so as to guide the reasonable clinical use of antibiotics. METHODS The distribution and drug resistance of P. aeruginosa isolated from various clinical specimens from the hospital from 2008 to 2011 were retrospectively analyzed. RESULTS A total of 420 strains of P. aeruginosa were isolated during the three years, the isolation rate was 4.44 %. Sputum was the main source of infections, from which 79 strains of P. aeruginosa were isolated, and secretions ranked the second, the P. aeruginosa strains were mainly distributed in the neurosurgery department （ 22. 38% ）, pneumology department （ 20. 95 % ）, and ICU （ 20.00 % ）. The result of drug susceptibility testing showed that the resistance rates to 17 kinds of antimicrobials showed an increasing trend, the strains were highly resistant to all the tested antibiotics except for imipenem; the drug resist- ance rates to imipenem, meropenem, cefoperazone/sulbactam, ceftazidime, amikacin, and levofloxacin were relatively low, with the drug resistance rates varying between 37.28% and 49.24% in 2011 ;the result of drug susceptibility testing showed that the resistance rates to sulfamethoxazole, amoxicillin/amoxicillin, ampicillin, centamicin, cefoxitin and cephalosporins except for ceftazidime were relatively high, reaching around 100. 0% in 2011; the drug resistance rates to aztreonam and cefoperazone/sulbactam were respectively 16. 67% and 17.24% in 2008, then starting to increase since 2009, and respectively reaching 54.05% and 42.35% in 2011; the drug resistance rates to imipenem and meropenem were 26.42% and 28.3%, respectively, starting to increase from 2009, and reaching respectively 37.24% and 45.18% in 2011. CONCLUSION The isolation rate and drug resistance of the P. aeruginosa strains keep an increasing tendency. It is mandatory for hospital to strengthen antimicrobial classification management, choose th
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第18期4532-4534,共3页
Chinese Journal of Nosocomiology
基金
内蒙古自然科学基金(2013MS1116)
关键词
铜绿假单胞菌
抗菌药物
耐药性
Pseudomonas aeruginosa
Antibiotic
Drug resistance
