不同年龄段患者铜绿假单胞菌感染的临床分布与耐药性分析
Clinical Distribution and Drug Resistance of Pseudomonas aeruginosa Infection in Patients of Different Ages
-
摘要: 目的 回顾性分析不同年龄段患者铜绿假单胞菌感染的临床分布及耐药情况, 为临床合理使用抗生素提供参考依据。方法 收集玉溪市人民医院2016年1～12月临床分离的铜绿假单胞菌, 进行药敏试验, 研究其临床分布及耐药特点。结果 从临床标本中共分离铜绿假单胞菌282株, 占临床总分离比例2.98%, 70岁以上老年患者感染所占比例较大 (41.5%) , 青少年群体感染几率较小 (3.2%) ;感染主要以呼吸道为主, 占80.9%, 大部分来源于痰液, 占77.7%, 其次为分泌物和尿液。铜绿假单胞菌抗菌药物耐药性因感染者年龄和感染部位不同存在差异。从年龄分布来看, 以哌拉西林、头孢他啶、头孢吡肟、亚胺培南和美罗培南差异较为显著 (P<0.05) , 老年患者对抗菌药物的耐药率普遍较高, 左旋氧氟沙星耐药率在31～50岁年龄段高于其他年龄;从不同标本类型分析, 除亚胺培南和呋喃妥因外, 所监测抗菌药物耐药性存在差异 (P<0.05) , 分泌物标本分离菌株耐药率在4组标本中最低, 尿液标本分离菌株耐药率明显高于其他标本 (P<0.05) 。结论 该院铜绿假单胞菌耐药率因临床分布不同存在差异, 临床应参考药敏结果合理使用抗菌素并加强其耐药性的监测, 防止及减少多重耐药及医院内感染的发生。Abstract: Objective To retrospectively analyze clinical distribution and drug resistance of pseudomonas aeruginosa infection in patients of different ages and provide reference for rational use of antibiotics in clinic.Methods Pseudomonas aeruginosa clinically isolated from yuxi people's hospital from January to December 2016 was collected for drug sensitivity test, and its clinical distribution and drug resistance characteristics were studied.Results A total of 282 strains of pseudomonas aeruginosa were isolated from clinical specimens, accounting for2.98% of the total clinical isolation. The infection rate of elderly patients over 70 years old accounted for a large proportion (41.5%) , and the infection rate of young people was relatively lower (3.2%) . The infection was mainly in respiratory tract, accounting for 80.9%, most of which were derived from sputum, accounting for77.7%, followed by secretions and urine. The antimicrobial resistance of pseudomonas aeruginosa varies with the age and site of infection, From the age distribution, piperacillin, ceftazidime, cefepime, imipenem and meropenem had significant differences (P < 0.05) , The drug resistance rate of elderly patients was generally higher, and the drug resistance rate of levofloxacin was higher than other ages in the 31-50 age group. From the different specimens, except imipenem and furantoin, the drug resistance of the antibiotics monitored was different (P < 0.05) , The drug resistance rate of isolates from secretion samples was the lowest among the four groups.The drug resistance rate of isolated strains in urine specimens was significantly higher than that of other specimens.Conclusion The drug resistance rate of pseudomonas aeruginosa in this hospital is different because of the different clinical distribution, and the drug susceptibility test should be used for the rational use of antibiotics and to strengthen the monitoring of drug resistance to prevent and reduce the occurrence of multiple drug resistance and infection in the hospital.
-
Key words:
- Pseudomonas aeruginosa /
- Clinical distribution /
- Drug-resistance
-
[1]张祎博, 孙景勇, 倪语星, 等.2005-2014年CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志, 2016, 16 (02) :141-145. [2]刘德华, 单斌, 杜艳, 等.2014年中国云南地区铜绿假单胞菌耐药监测[J].国际检验医学杂志, 2017, 38 (08) :1066-1068. [3]中华人民共和国医政司.全国临床检验操作规程 (第3版) [M].南京:东南大学出版社, 2006:737-738. [4] [4]Clinical and laboratory Standard Institute.M100-S24 Performance standards for antimicrobial susceptibility testing:twenty-Fourth informational supplement[M].Wayne, PA:CLSI, 2014:58-61. [5] [5]JONES R N.Microbial etiologies of hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia[J].Clin Infect Dis, 2010, 51 (Suppl) :s81-s87. [6]吴敏, 张丽霞, 张立, 等.2010-2013年本院铜绿假单胞菌的临床分布和耐药性分析[J].国际检验医学杂志, 2015, 36 (07) :908-910. [7]王詝, 孙珊.某大型教学医院2013—2015年铜绿假单胞菌的耐药性监测[J].中国抗生素杂志, 2017, 42 (07) :586-591. [8]刘刚, 魏莲花, 邹凤梅, 等.427株铜绿假单胞菌的临床分布和耐药性分析[J].甘肃医药, 2017, 36 (07) :531-533. [9]胡光.某医院铜绿假单胞菌临床分布与耐药特征分析[J].中国预防医学杂志, 2017, 18 (02) :153-155. [10]王志勤, 邢志广, 廖卫, 等.2013-2015年新乡市692株铜绿假单胞菌临床分布及耐药性分析[J].现代预防医学, 2017, 44 (03) :550-552+560. [11]解泽强, 菅记涌, 孙盼盼, 等.2010-2015年医院铜绿假单胞菌感染分布及耐药性分析[J].中华医院感染学杂志, 2017, 27 (03) :498-500+504. [12] [12]BOGAN C, KAYE K S, CHOPRA T, et al. Outcomes of carbapenem-resistant Enterobacteriaceae isolation:Matched analysis[J]. American Journal of Infection Control, 2014, 42 (6) :612-620. [13]查长森, 姚长英.铜绿假单胞菌的耐药分析及临床分布[J].国际检验医学杂志, 2015, 36 (15) :2251-2252. [14] [14]APONTE F E, TABOADA B, ESPINOZA M A, et al.Rhinovirus is an important pathogen in upper and lower respiratory tract infections in Mexican children[J]. Virology Journal, 2015, 12 (1) :31. [15] [15]YAN P, CHEN Y, SONG Z, et al. Pathogenic effects of biofilm with chronic Pseudomonas aeruginosa lung infection in rats[J]. Journal of Nanjing Medical University, 2008, 22 (1) :34-38. [16] [16]EL SOLH A A, ALHAJHUSAIN A. Update on the treatment of Pseudomonas aeruginosa pneumonia[J]. Journal of Antimicrobial Chemotherapy, 2009, 64 (2) :229-238. [17]施晓群, 孙景勇, 倪语星, 等.2011年中国CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志, 2013, 13 (3) :218-221. -
点击查看大图
计量
- 文章访问数: 2813
- HTML全文浏览量: 940
- PDF下载量: 79
- 被引次数: 0
下载:
