ICU病房与普通病房铜绿假单胞菌耐药性分析

发布时间：2018-01-17 02:33

本文关键词：ICU病房与普通病房铜绿假单胞菌耐药性分析　出处：《西部医学》2017年01期 　论文类型：期刊论文

【摘要】：目的分析ICU病房与普通病房分离的铜绿假单胞菌对抗菌药物的耐药性,为临床治疗用药提供参考。方法采用K-B法进行药敏试验,以CLSI 2012年版判断标准分析临床分离株的敏感性,分析采用WHONET5.4及SPSSl8.0统计软件。结果 2011年1月~2014年12月共分离出铜绿假单胞菌1275株,其中ICU病房分离出452株,占35.5%;分离的菌株主要来源于呼吸道痰标本,占70.1%。ICU中分离的铜绿假单胞菌对阿米卡星的耐药率最低,为19.0%;对头孢哌酮的耐药率最高,为47.3%;对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢他啶、头孢吡肟的耐药在21.0%~34.3%之间;对亚胺培南的耐药率高达36.3%。普通病房(内、外科及其它科)中分离出823株,其对阿米卡星的耐药率仍然最低,为10.9%;其后由低到高依次为头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、亚胺培南、美洛西林、环丙沙星、庆大霉素、哌拉西林、氨曲南、头孢哌酮,其耐药率介于12.5%~39.9%之间。ICU中铜绿假单胞菌对常用抗菌药物的耐药性及多重耐药菌株的检出率均要显著高于普通病房,且铜绿假单胞菌对抗菌药物的耐药性与相应的用药频度有关。结论 ICU中多重耐药铜绿假单胞菌耐药性仍是监控重点。通过分析铜绿假单胞菌的耐药性,有利于指导临床合理用药及减缓细菌耐药的发生。
[Abstract]:Objective to analyze the antimicrobial resistance of Pseudomonas aeruginosa isolated from ICU wards and general wards, and to provide a reference for clinical treatment. The sensitivity of clinical isolates was analyzed according to the criteria of CLSI 2012. Results from January 2011 to December 2014, 1275 strains of Pseudomonas aeruginosa were isolated. 452 strains (35. 5%) were isolated from ICU ward. The isolates were mainly isolated from respiratory sputum, accounting for 70.1. The resistance rate of Pseudomonas aeruginosa to amikacin was the lowest (19.0) in ICU. The rate of resistance to cefoperazone was the highest (47.3%). Resistance to piperacillin / tazobactam, cefoperazone / sulbactam, ceftazidime and cefepime was between 21.0% and 34.3%; The resistance rate to imipenem was as high as 36.3%. 823 strains were isolated from general wards (internal, surgical and other departments), and the resistance rate to amikacin was still the lowest (10.9%). Then cefoperazone / sulbactam, piperacillin / tazobactam, cefepime, ceftazidime, imipenem, meloxicillin, ciprofloxacin, gentamicin, piperacillin and aztreonam were followed by the low to high order. The drug resistance rate of cefoperazone was between 12.5% and 39.9%. The resistance of Pseudomonas aeruginosa to common antibiotics and the detection rate of multidrug resistant strains in ICU were significantly higher than those in general wards. The drug resistance of Pseudomonas aeruginosa to antimicrobial agents is related to the frequency of drug use. Conclusion the drug resistance of multidrug resistant Pseudomonas aeruginosa in ICU is still the focus of monitoring. The drug resistance of Pseudomonas aeruginosa is analyzed by analyzing the drug resistance of Pseudomonas aeruginosa. It is helpful to guide rational drug use in clinic and to slow down the occurrence of bacterial drug resistance.
【作者单位】：华中科技大学同济医学院附属荆州医院感染科;重庆医科大学附属第一医院感染科·重庆市传染病寄生虫病学重点实验室;
【基金】：人事部科研基金(09958013) 重庆市自然科学基金(CSTC2009BB5061)
【分类号】：R446.5;R459.7
【正文快照】： 2.重庆医科大学附属第一医院感染科·重庆市传染病寄生虫病学重点实验室,重庆400016)铜绿假单胞菌是医院感染最常见的病原菌,属条件致病菌,在免疫力低下的患者中可引起严重甚至致死性的感染,如肺部感染、败血症、泌尿系感染、脑膜炎等。ICU患者因存在各种致免疫力低下的潜在危

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