摘要
目的统计大连市友谊医院近六年来铜绿假单胞菌感染的菌株来源与临床分布,分析11种临床常见抗菌药的耐药情况,为临床治疗铜绿假单胞菌感染及合理使用抗菌药物提供理论依据。方法回顾性分析我院2017年1月-2022年12月铜绿假单胞菌感染的临床送检标本1316株,进行细菌体外分离培养与药敏实验,应用Whonet 5.6软件分析药敏结果,Spss 23软件对6年内该菌耐药率的变化进行卡方检验。结果1316株铜绿假单胞菌中,主要来源于痰液907株(68.9%)和尿液167株(12.7%)。这些菌株主要分布于重症医学科513株(39.0%)和老年病科359株(27.3%)。在所统计的11种抗生素中,哌拉西林/他唑巴坦、头孢吡肟和氨曲南三种药物6年内耐药率变化显著,具有统计学意义(P<0.05);其间耐药率最高的是2021年左氧氟沙星(37.0%),耐药率最低的是2022年头孢吡肟(8.3%)。结论本院铜绿假单胞菌的碳青霉烯类和喹诺酮类耐药率较高,哌拉西林/他唑巴坦呈耐药率逐年上升;微生物室应加强耐药菌监测的同时,临床也要加强抗菌药物的管理。
Objective A theoretical foundation for the clinical treatment of Pseudomonas aeruginosa(PAE)infection and the prudent use of antibacterial drugs was provided by an analysis of the source and clinical distribution of PAE infection in the last six years at Dalian Friendship Hospital,as well as an examination of the resistance of eleven common clinical antibacterial drugs.Methods Using Whonet 5.6 software,we conducted a retrospective analysis of 1316 strains of PAE infection from January 2017 to December 2022.We also isolated and cultured bacteria in vitro and conducted drug susceptibility experiments.Finally,we used Spss 23 software to perform a chi-square test on the change in drug resistance rate of this bacterium within three years.Results Among the 1316 strains of PAE,907 strains(68.9%)of sputum and 167 strains(12.7%)of urine were mainly derived from bronchoalveolar lavage fluid,bile,secretions,etc.These strains were mainly distributed in ICU 513 strains(39.0%)and geriatrics 359 strains(27.3%).Among the 1l antibiotics,the resistance rate of piperacillin/tazobactam,cefepime,and aztreonam changed significantly within 6 years(P<0.05).The highest resistance rate during this period was levofloxacin in 2021(37.0%),and the lowest resistance rate was cefepime in 2022(8.3%).Conclusion The resistant rates of PAE to carbapenem and quinolones were high.The drug resistance rate of piperacillin/tazobactam increased year by year.The surveillance of drug-resistant bacteria should be strengthened and the management of antibiotics should be strengthened in the clinic.
作者
郑远明
董智慧
周杰
由函琳
Zheng Yuan-ming;Dong Zhi-hui;Zhou Jie;You Han-lin(Afiliated Dalian Friendship Hospital of Dalian Medical University,Dalian 116001;Dalian Medical University,Dalian 116000)
出处
《国外医药（抗生素分册）》
CAS
2024年第3期169-174,共6页
World Notes on Antibiotics
关键词
铜绿假单胞菌
临床分布
耐药性
抗菌药物
耐药菌监测
多重耐药
Pseudomonas aeruginosa
clinical distribution
drug resistance
antibiotics
surveillance of drug-resistant bacteria
multi-drug resistance
