2011-2015年开放伤口感染铜绿假单胞菌耐药性变迁研究

发布时间：2018-10-20 16:06

【摘要】：目的了解开放伤口感染标本中分离的铜绿假单胞菌耐药性变迁,为临床合理使用抗菌药物提供依据。方法收集2011-2015年医院收治创伤患者开放伤口的分泌物,病原学鉴定采用VITEK-2全自动微生物鉴定系统,药敏试验采用K-B纸片扩散法,按照美国临床和实验室标准化研究所标准判断,数据用WHONET5.6及SPSS20.0统计软件进行分析。结果 2011-2015年创伤患者开放伤口标本中铜绿假单胞菌检出率分别为11.81%、11.46%、13.11%、13.75%、14.13%;创伤患者铜绿假单胞菌感染科室以骨科、普外科和烧伤整形科检出较多,依次为骨科、普外科、烧伤整形科、ICU及脊柱科,分别占42.03%、19.81%、14.98%、7.25%及5.31%;铜绿假单胞菌对阿米卡星、哌拉西林/他唑巴坦和亚胺培南耐药性较低,分别为11.76%、17.65%、13.73%,对大部分抗菌药物耐药性均呈上升趋势。结论创伤患者开放伤口铜绿假单胞菌感染率与耐药性显上升趋势,临床应做好彻底清创止血,严格无菌操作观念,合理选用抗菌药物,对环境及设备严格消毒隔离措施,提高手卫生依从性,减少耐药菌株扩散。
[Abstract]:Objective to investigate the changes of drug resistance of Pseudomonas aeruginosa isolated from open wound infection specimens and to provide evidence for rational use of antibiotics in clinic. Methods the secretions of open wound were collected from patients with trauma in our hospital from 2011 to 2015. VITEK-2 automatic microbiological identification system was used for etiological identification, K-B disk diffusion method was used for drug sensitivity test, and the results were judged according to the standards of American Institute of Clinical and Laboratory Standardization. The data were analyzed by WHONET5.6 and SPSS20.0 software. Results the positive rates of Pseudomonas aeruginosa in open wound specimens of trauma patients from 2011 to 2015 were 11.81 and 11.46, respectively. The infection rate of Pseudomonas aeruginosa in trauma patients was found in orthopedics, general surgery and orthopedics, followed by orthopedics and general surgery. The antimicrobial resistance of Pseudomonas aeruginosa to amikacin, piperacillin / tazobactam and imipenem was lower, which was 11.760.17.65% and 13.73, respectively. The drug resistance of Pseudomonas aeruginosa to amikacin, piperacillin / tazobactam and imipenem was increased. Conclusion the infection rate and drug resistance of Pseudomonas aeruginosa in open wound of trauma patients are on the rise. It is necessary to make thorough debridement and hemostasis, strict aseptic operation concept, rational selection of antimicrobial agents and strict disinfection and isolation measures for environment and equipment. Improve hand hygiene compliance and reduce the spread of drug resistant strains.
【作者单位】：贵州医科大学第三附属医院骨科;贵州医科大学第三附属医院感染管理科;贵州医科大学第三附属医院检验科;贵州省人民医院感染管理科;
【基金】：贵州省科技厅联合基金资助项目(黔科合LH字[2014]7162) 贵州省黔南州社会发展科技基金资助项目(黔南科合社字[2013]20)
【分类号】：R446.5

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