Analysis on distribution and drug resistance of 136 strains of hospital-acquired Pseudomonas aeruginosa related with bloodstream infections
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摘要: 目的 医院获得性铜绿假单胞菌血流感染的发病率和病死率有升高的趋势,本文通过分析该菌血流感染的临床分布特征及耐药情况,为临床预防感染及诊疗提供依据。 方法 对解放军总医院2010年1月—2014年12月院内铜绿假单胞菌血流感染患者的科室分布、基础疾病分布情况进行回顾性分析,对培养分离出的铜绿假单胞菌采用纸片扩散法(K-B法)进行药敏实验,使用WHONET 5.6软件对药敏结果进行分析,并使用SPSS 17.0统计学软件对近几年该菌耐药率变化进行统计分析。 结果 2010年1月—2014年12月共从血标本中分离出符合标准的铜绿假单胞菌136株,其中34株(25.00%)分布于重症监护室、23株(16.91%)分布于血液科、14株(10.29%)分布于消化内科、13株(9.56%)分布于呼吸内科,其他涉及科室还包括儿科、肝胆外科等;感染患者中,41例(30.15%)患恶性实体肿瘤,28例(20.59%)患白血病;136株血流感染铜绿假单胞菌中检出22株多重耐药菌(占16.18%);血流感染铜绿假单胞菌对碳青霉烯类抗菌素如亚胺培南、美罗培南表现出高的耐药率,分别为33.09%、26.47%;对阿米卡星、头孢吡肟、环丙沙星的耐药率相对较低,分别为13.24%、16.18%、18.38%。近几年来,血流感染铜绿假单胞菌对各种常见的抗菌药物的耐药率变化差异均无统计学意义(P>0.05),但对头孢哌酮、氨曲南、亚胺培南、左旋氧氟沙星的耐药率有升高趋势。 结论 铜绿假单胞菌血流感染在该院分布广泛,菌株对常用抗菌素表现出一定程度的耐药,临床应加强耐药性监测,根据药敏结果合理使用抗菌药物。Abstract: Objective The morbidity and mortality of hospital-acquired Pseudomonas aeruginosa related with bloodstream infections presented an increased trends recently. This article aimed to analyze clinical distribution and drug resistance of hospital-acquired pseudomonas aeruginosa bacteremia to provide reference for clinical prevention and treatment. Methods The distribution and comorbidity of patients suffered from pseudomonas aeruginosa bacteremia from January,2010 to December,2014 in PLA general hospital were analyzed retrospectively. The susceptibility to antimicrobials of Pseudomonas aeruginosa isolated from blood specimens was tested by Kirby-Bauey methods and the results were performed using WH0 NET 5. 6. At the same time,the differences of drug resistance ratio in recent years were analyzed using SPSS17. 0. Results Total 136 strains of pseudomonas aeruginosa were isolated from blood specimens from January,2010 to December,2014,34 strains(25. 00%) of which distributed in Intensive Care Unit,23 strains(16. 91%) in department of hematology,14 strains(10. 29%) in department of gastroenterology,13 strains(9. 56%) in department of respiratory and so on. The patients with malignant cancers and leukemia were easily affected with bloodstream infections caused by pseudomonas aeruginosa,accounting for 30. 15% and 20. 59%,respectively. Twenty-two strains were multi-drug resistant pseudomonas aeruginosa,the detection rate was 16. 18%. Pseudomonas aeruginosa was seriously resistant to carbopenems,such as imipenem and meropenem,the rates were 33. 09% and 26. 47%,respectively,while Pseudomonas aeruginosa had low resistance rates to amikacin,cefepime,ciprofloxacin,the rates were 13. 24%,16. 18%,18. 38% respectively. The differences of drug resistance ratio of common antibiotics in recent years were not significant(P > 0. 05),but resistance rates of cefoperazone,aztreonam,imipenem,levofloxacin presented increased trends. Conclusion Pseudomonas aeruginosa bacteremia distributes widely in our hospital. The drug resistance of pseudomonas aeruginosa related with bloodstream infections is a bit serious,so drug resistance test should be strengthened and the clinical application of antibiotics should be performed based on the result of drug susceptibility test.
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Key words:
- Pseudomonas aeruginosa /
- Bloodstream infections /
- Distribution /
- Drug resistance
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