铜绿假单胞菌医院感染的调查与耐药性分析

发布时间：2018-10-21 16:50

【摘要】：目的探讨铜绿假单胞菌医院感染的分布情况及耐药性。方法收集2015年1月-2016年12月铜绿假单胞菌医院科室临床分离株170株,采用琼脂扩散法(K-B法)对170株铜绿假单胞菌进行药敏试验,分析铜绿假单胞菌的标本来源分布及对15种常用抗菌药物的药敏率,并探讨抗菌药物单独用药与联合用药对铜绿假单胞菌的治疗效果。结果铜绿假单胞菌标本来源主要为呼吸道标本,检出率为59.4%,其次为尿液,检出率为12.4%,且铜绿假单胞菌医院感染主要集中在ICU、神经外科、呼吸内科等科室;药物敏感试验显示铜绿假单胞菌对临床中常用的15种抗菌药物均有严重耐药性,其中对氨苄西林/舒巴坦的耐药率最高,达到74.7%,其次为头孢噻肟,耐药率为70.6%,对环丙沙星的耐药率最低,为18.8%;6组联合抗菌药物协同累加率为43.52%~88.47%,联合抗菌治疗效果最佳为头孢他啶与环丙沙星,达到92.9%,其次为环丙沙星与哌拉西林他唑巴坦钠的联合,达到78.8%,抗菌药物联合应用敏感率与单独用药敏感率呈现显著差异(P0.05)。结论铜绿假单胞菌有较高的耐药性,应加强临床监测与控制,对铜绿假单胞菌给予抗菌药物联合给药,增强体外抗菌活性。
[Abstract]:Objective to investigate the distribution and drug resistance of Pseudomonas aeruginosa nosocomial infection. Methods 170 clinical isolates of Pseudomonas aeruginosa were collected from January 2015 to December 2016, and 170 strains of Pseudomonas aeruginosa were tested by Agar diffusion assay (K-B method). The origin and distribution of Pseudomonas aeruginosa samples and their susceptibility to 15 common antimicrobial agents were analyzed, and the therapeutic effects of antibiotics alone and in combination on Pseudomonas aeruginosa were discussed. Results the samples of Pseudomonas aeruginosa were mainly from respiratory tract (59.4%), followed by urine (12.4%). The nosocomial infection of Pseudomonas aeruginosa was mainly in ICU, neurosurgery, respiratory department and other departments. The drug sensitivity test showed that Pseudomonas aeruginosa had serious resistance to 15 kinds of antimicrobial agents commonly used in clinic. The resistance rate to ampicillin / sulbactam was the highest (74.7%), followed by cefotaxime. The resistance rate to ciprofloxacin was the lowest, and the synergistic accumulation rate of antibacterials was 43.52 and 88.477.The best antibacterial effect was ceftazidime and ciprofloxacin, and the best antimicrobial effect was ceftazidime and ciprofloxacin, and the synergistic accumulative rate was 43.52 and 88.477.The best antimicrobial effect was ceftazidime and ciprofloxacin. 92.9%, followed by ciprofloxacin and piperacillin tazobactam sodium, reached 78.8%, the antimicrobial drug combination sensitivity rate and single drug sensitivity rate showed significant difference (P0.05). Conclusion Pseudomonas aeruginosa has high drug resistance, so clinical monitoring and control should be strengthened, combined administration of antimicrobial agents against Pseudomonas aeruginosa should be carried out to enhance its antibacterial activity in vitro.
【作者单位】：浙江金华市中心医院药剂科;浙江金华市中心医院检验科;
【基金】：浙江省卫计委临床医学会临床科研基金资助项目(2011ZYC-B5)
【分类号】：R446.5

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