豫北地区铜绿假单胞菌感染分布和耐药性的分析

摘要

目的 了解铜绿假单胞菌(PA)感染分布及其耐药情况,指导临床医生合理使用抗生素,有效预防及控制院内感染.方法 应用美国Dade MicmScall公司生产的Auto SCAN4半自动鉴定仪及配套的生化反应药敏板进行鉴定.参照2014版CLSI标准进行药敏结果判读.结果 2014-2015年间共收集534株多重耐药铜绿假单胞菌菌株,其中男性感染者占71.35%(381/534),且年龄分布在60~69岁者最多.标本类型主要是痰液(413份, 77.34%),其次为分泌物(47份,8.80%)和中段尿(24份,4.49%).分离的铜绿假单胞菌主要分布在神经外科18.54%(99/534)、呼吸科16.10%(86/534)和重症监护室12.92%(69/534)三个科室.铜绿假单胞菌对16种抗生素的药敏试验显示耐药率较低的药物有阿米卡星(21.72%)、哌拉西林/他唑巴坦(26.78%),而头孢唑林、氨苄西林/舒巴坦则耐药率较高,均为99.63%.结论 铜绿假单胞菌对抗菌药物存在多重耐药性且耐药率高,临床医生应根据其临床分布特点和药敏试验结果合理选择抗菌药物.%Objective To investigate the distribution of Pseudomonas aeruginosa (PA) infection and the drug resistance situation, guide the reasonable use of antibiotics in clinic, and effectively prevent and control nosocomial in-fection. Methods Semi-automatic identification system Auto SCAN4 (American Dada MicmScall company) and the matching biochemical drug susceptibility plate were used for the identification of PA infection, and the CLSI standard the (2014 edition) was used for interpreting the drug sensitivity results. Results During the period of 2014 to 2015, a total of 534 strains of multi-resistant Pseudomonas aeruginosa were collected, including 381 strains from male patients (71.35%, 381/534), whose age mainly distributed in the range of 60~69. The main type of specimens was sputum (413 specimens, 77.34%), followed by secretion (47 specimens, 8.80%) and urine (24 specimens, 4.49%). Pseudomonas ae-ruginosa mostly distributed in the Department of Neurosurgery (18.54%, 99/534), the Department of Respiration (16.10%, 86/534) and Intensive Care Unit (12.92%, 69/534). Drug sensitivity test of Pseudomonas aeruginosa to 16 kinds of antibiotics showed low drug resistance rate in Amikacin (21.89%), Piperacillin/Tazobactam (26.93%), and high drug resistance rate in Cefazolin, Arnpicillin/sulbactam (up to 99.81%). Conclusion Pseudomonas aeruginosa shows multi-resistance to antibiotics, and the drug resistance is high. Clinicians should choose antimicrobial agents reasonably according to the characteristics of clinical distribution and drug susceptibility test results.