Objective To compare clinical Pseudomonas aeruginosa different sources of β-lactamase-resistant phenotype differences,as to provide theoretical basis for guiding clinical rational use of antibiotics.Methods Isolation of 478 strains of Pseudomonas aeruginosa were collected from clinical specimens in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2015,by VITEK 2 Compact bacteria identification and drug sensitivity analysis of advanced expert system for β-lactamase-resistant phenotype,statistical analysis of drug resistance phenotype and antibiotic resistance.Results 478 strains of Pseudomonas aeruginosa were mainly composed of phenotype 5 and phenotype 3.Sputum,drainage fluid and bile duct bile specimens of Pseudomonas aeruginosa were based on phenotype 5,accounted for 31.08％,34.71％ and 38.46％.Multiple comparison x2 were 3.893,4.071 and 5.595,There was no statistical difference between groups compare significance (P＞0.05).Urine,secretions and whole blood samples of Pseudomonas aeruginosa were phenotype 3,accounted for 34.88 ％,27.78 ％,45.45 ％;Multiple comparison x2 were 6.654,9.956 and 9.852.There was no statistical difference between groups compare significance (P＞0.05).Sputum,drainage of liquid,bile duct bile and urine,secretion,whole blood specimens respectively source of Pseudomonas aeruginosa resistant phenotype distribution of two comparative difference was statistically significant (x2 =15.056～22.050,P＜0.05).Comparing the resistance of different β-lactamase-resistant phenotypes in Pseudomonas aeruginosa isolates from different sources:the sputum specimen source in imipenem,meropenem,piperacillin and piperacillin/tazobactam had significant difference (x2 =22.225～39.025,P＜0.05).There was statistical significance in department of hepatobiliary surgery only ceftazidime and meropenem differences (x2 =21.890～22.872,P＜0.05).Conclusion The phenotypic analysis of β-lactamase-resistant phenotypes of Pseudomonas aeruginosa from different specimens was different,which provided a theoretical basis for guiding the clinical application of antibiotics and the control of nosocomial infection of Pseudomonas aeruginosa.%目的 比较临床不同来源铜绿假单胞菌对β-内酰胺酶耐药表型差异性,为指导临床合理使用抗生素提供理论依据.方法 收集西安交通大学第一附属医院2015年1月～12月从临床标本中分离的478株铜绿假单胞菌,通过VITE-K2 Compact细菌鉴定及药敏分析高级专家系统获得β-内酰胺酶耐药表型,对其耐药表型和相关抗生素的耐药性做差异性统计分析.结果 478株铜绿假单胞菌以表型5和袁型3为主.痰液、引流液、胆管胆汁标本来源铜绿假单胞菌均以表型5为主,分别占31.08％,34.71％和38.46％,两两比较各组差异无统计学意义(x2值分别为3.893,4.071,5.595,P＞0.05).尿液、分泌物、全血标本来源铜绿假单胞菌均以表型3为主,分别占34.88％,27.78％和45.45％,两两比较各组差异无统计学意义(x2值分别为6.654,9.956,9.852,P＞0.05).痰液、引流液、胆管胆汁分别与尿液、分泌物、全血标本来源铜绿假单胞菌耐药表型分布两两比较差异有统计学意义(x2 =15.056～22.050,P＜0.05).通过对不同标本来源铜绿假单胞菌中不同β-内酰胺酶耐药表型抗生素耐药性比较:痰液标本来源中亚胺培南、关罗培南、哌拉西林、哌拉西林/他唑巴坦差异有统计学意义(x2=22.225～39.025,P＜0.05);肝胆外科仅头孢他啶和美罗培南差异有统计学意义(x2=21.890～22.872,P＜0.05).结论 不同标本来源铜绿假单胞菌对β-内酰胺酶耐药表型的比较分析有差异性,为指导临床合理应用抗生素及铜绿假单胞菌的医院感染控制提供了理论依据.
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