摘要
目的探讨铜绿假单胞菌的临床分布与耐药性变迁,为重点区域的防控及临床合理用药提供参考依据。方法抽取北京中医药大学东直门医院2018年1月至2021年12月分离的铜绿假单胞菌,采用WHONET 5.6和SPSS 26软件对数据进行菌株分离情况、科室分布、标本类型及耐药情况的分析。结果2018年1月至2021年12月共分离出革兰氏阴性杆菌7621株,其中PA占19.88%共1515株,占比连续4年下降。主要分布于周围血管科512株(33.8%)和重症监护病房447株(29.5%)。骨科和脑病科呈上升趋势,急诊监护病房呈下降趋势。主要来源于呼吸道830株(54.79%),脓液及分泌物580株(38.28%),尿液73株(4.82%),及其他标本32株(2.11%)。除其他标本类型外,各标本类型在不同年度间的变化差异均无统计学意义(P>0.05)。PA耐药率从高到低依次为:左氧氟沙星48.19%、亚胺培南46.82%、氨曲南46.05%、美罗培南40.44%、环丙沙星33.89%、头孢他啶28.81%、头孢吡肟28.34%、哌拉西林26.99%、哌拉西林/他唑巴坦22.90%和庆大霉素10.92%。其中哌拉西林、哌拉西林/他唑巴坦、头孢他啶、头孢吡肟和氨曲南均呈下降趋势。结论铜绿假单胞菌主要分布在周围血管科和重症监护病房,主要来源于呼吸道。虽然其检出率以及哌拉西林、哌拉西林/他唑巴坦、头孢他啶、头孢吡肟和氨曲南的耐药率均呈下降趋势,但仍高于全国耐药监测网(CARSS)发布的同期数据,因此仍需加强重点科室感染管理以及抗菌药物监测。
Objective To investigate the clinical distribution and drug resistance of Pseudomonas aeruginosa in order to provide reference for prevention and control in key areas and clinical rational drug use.Methods Pseudomonas aeruginosa isolated from Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2018 to December 2021 were selected,and WHONET 5.6 and SPSS 26 software were used to analyze the data of strain isolation,department distribution,specimen type and drug resistance.Results From January 2018 to December 2021,a total of 7621 strains of Gram-negative bacilli were isolated,of which 19.88%were PA,1515 strains.The share has fallen for four consecutive years.Mainly distributed in peripheral vascular department 512 strains(33.8%)and intensive care unit 447 strains(29.5%).The orthopedics and encephalopathy departments are on the rise,and the emergency care units are on the decline.Mainly from respiratory tract 830 strains(54.79%),pus and secretions 580 strains(38.28%),urine 73 strains(4.82%),and other specimens 32 strains(2.11%).Except for other specimen types,there was no statistical difference between different years(P>0.05).The resistance rate of PA from high to low is:Levofloxacin 48.19%,imipenem 46.82%,amtraxam 46.05%,ciprofloxacin 33.89%,meropenem 33.79%,ceftazidime 28.81%,cefepime 28.34%,piperacillin 26.99%,piperacillin/tazobactam 22.90%and gentamicin 10.92%.Among them,piperacillin,piperacillin/Tazobactam,ceftazidime,cefepime and amtraxam all showed a decreasing trend.Conclusion Pseudomonas aeruginosa mainly distributed in peripheral vascular department and intensive care unit,and mainly originated from respiratory tract.Although its detection rate and resistance rates of piperacillin,piperacillin/tazobactam,ceftazidime,cefepime and amtraxam all showed a downward trend,they were still higher than the corresponding data released by the National Drug Resistance Monitoring Network(CARSS).Therefore,it is still necessary to strengthen infection management and antibacterial drug monitoring in key departments.
作者
杨玉婷
马婧涵
周航宇
林英
刘月红
贾悦
姚兴伟
YANG Yuting;MA Jinghan;ZHOU Hangyu;LIN Ying;LIU Yuehong;JIA Yue;YAO Xingwei(Dongzhimen Hospital Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国实验诊断学》
2023年第11期1288-1292,共5页
Chinese Journal of Laboratory Diagnosis
关键词
铜绿假单胞菌
抗菌药物
耐药性
pseudomonas aeruginosa
antimicrobial drugs
drug resistance
作者简介
通信作者:姚兴伟
