【摘要】 目的了解金昌地区医院感染铜绿假单胞菌(PAE)的临床分布特点及耐药性,为合理应用抗菌药物和预防控制医院感染提供依据。方法收集金昌地区5所综合医院2010-2011年分离的医院感染PAE,按照《全国临床检验操作规程》进行鉴定;采用CLSI推荐的方法(K-B法)进行药敏试验和结果评价。结果分离的463株PAE主要来源于ICU和呼吸内科,分别占28.5%和25.5%;感染标本来源最多的是呼吸道标本,占70.6%,其次是分泌物和尿液,分别占14.5%和6.7%;463株PAE对头孢哌酮/舒巴坦的耐药率为11.7%,其次为美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星、头孢他啶,耐药率在20.7%～25.5%,耐药率最高的为头孢噻肟和氨苄西林/舒巴坦,分别为67.0%和66.1%;共检出耐亚胺培南PAE107株,耐药率23.1%多药耐药铜绿假单胞菌,(MDRPA)58株,检出率泛耐药铜绿假单胞菌12.5%(PDRPA)23株,检出率5.0%,ICU患者MDRPA和PDRPA的检出率明显高于其他病区(P<0.05)。结论PAE引起的医院感染越来越严重,耐药性呈上升趋势,ICU及老年患者居多的科室是预防控制的重点科室。更多还原

【Abstract】 OBJECTIVE To investigate the clinical distribution and the drug resistance of Pseudomonas aeruginosa causing nosocomial infections in Jinchang so as to provide the reference for reasonable use of antibiotics and prevention and control of nosocomial infections.METHODS The P.aeruginosa isolated from five general hospitals in Jinchang from 2010 to 2011 were collected and identified by referring to National Guide to Clinical Laboratory Procedures.The drug susceptibility testing was performed by K-B methods recommended by CLSI.The testing results were assessed.RESULTS Totally 463 strains of P.aeruginosa were mainly isolated from ICU and respiratory department,accounting for 28.5% and 25.5%,respectively.Most of the strains were collected from respiratory tract specimens,accounting for 70.6%,followed by secretions(14.5%) and urine(6.7%).Totally 463 isolates showed the lowest drug resistance rate to cefoperazone/sulbactam(11.7%),followed by meropenem,imipenem,piperacillin/tazobactam,amikacin,ceftazidime(varying from 20.7% to 25.5%),The drug resistance rates of P.aeruginosa to cefotaxime(67.0%) and ampicillin/sulbactam(66.1%) were the highest.A total of 107 imipenem-resistant P.aeruginosa isolates(23.1%),58 multidrug-resistant P.aeruginosa isolates(12.5%) and 23 pan-resistant strains(5.0%) were detected,the detection rates of the MDRPA and PDRP in ICU were significantly higher than in other wards(P<0.05).CONCLUSION The nosocomial infections caused by P.aeruginosa become more and more serious,and the resistance rate shows an increasing tendency.It is necessary to focus on the prevention and control of the nosocomial infections in the ICU and the departments with the majority of elderly patients.更多还原