中国循证医学杂志

中国循证医学杂志

中国医学科学院阜外医院 2013~2016 年分离铜绿假单胞菌的分布及耐药性分析

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目的 回顾性分析中国医学科学院阜外医院 2013~2016 年铜绿假单胞菌的分离率及其耐药特点。 方法 对送检标本进行采集和培养,若分离的细菌来自同一患者的相同部位,以首次分离出的菌株计数。对分离出的致病菌做鉴定及药敏实验。 结果 共分离铜绿假单胞菌 1 404 株,分离菌株主要来自外科术后恢复室(62.1%),其次为内科 ICU(22.3%)。标本来源以呼吸道为主(75.7%),其次为血培养(10.0%)及静脉导管(5.5%)。铜绿假单胞菌对哌拉西林、哌拉西林/舒巴坦的耐药率为 0.6%~10.4%;对头孢他啶、头孢吡肟的耐药率为 0.3%~11.7%;对亚胺培南、美罗培南的耐药率为 7.6%~20.1%;对阿米卡星、庆大霉素、妥布霉素的耐药率为 0.3%~3.2%;对环丙沙星、左氧氟沙星的耐药率为 0.6%~5.2%。 结论 外科术后恢复室和内科 ICU 是铜绿假单胞菌感染的主要科室。亚胺培南、美罗培南不是治疗铜绿假单胞菌感染的最佳选择。哌拉西林、哌拉西林/舒巴坦、头孢他啶、头孢吡肟与氨基糖苷类或喹诺酮类抗生素联合应用对治疗铜绿假单胞菌感染,避免其产生耐药有重要的临床价值。

Objectives To retrospectively analyze the isolation rate and drug-resistance of pseudomonas aeruginosa in Fuwai Hospital of Chinese Academy of Medical Sciences from 2013 to 2016. Methods The specimens were collected and cultured. If the isolated bacteria were from the same part of the same patient, the first isolated strains were only counted. The isolated pathogens were identified and the drug-resistance were analyzed. Results A total of 1 404 pseudomonas aeruginosa were isolated. The majority of them were from postoperative recovery room of surgery department (62.1%) and ICU of internal medicine (22.3%). The specimen source were mainly from respiratory tract (75.7%), followed by blood (10.0%) and venous catheter (5.5%). The resistance rate of piperacillin and piperacillin/sulbactam to pseudomonas aeruginosa was 0.6% to 10.4%. The resistance rate of ceftazidime and cefepime was 0.3% to 11.7%. The resistance rate of imipenem and meropenem was 7.6% to 20.1%. The resistance rate of amikacin, gentamicin, and tobramycin was 0.3% to 3.2%. The resistance rate of ciprofloxacin and levofloxacin was 0.6% to 5.2%. Conclusions The isolates of pseudomonas aeruginosa are mainly from postoperative recovery room of surgery department and ICU of internal medicine . Imipenem and meropenem are not the best choices for pseudomonas aeruginosa infection. It has great value to combine piperacillin, piperacillin/sulbactam, ceftazidime and cefepime with aminoglycoside or quinolone antibiotics for the treatment of pseudomonas aeruginosa infection which will reduce drug resistance.

关键词: 心血管病; 铜绿假单胞菌; 耐药性; 抗生素

Key words: Cardiovascular disease; Pseudomonas aeruginosa; Drug-resistance; Antibiotics

引用本文: 程军, 耿洁, 李峰, 张思明, 高小晶, 张燕搏, 王飞燕. 中国医学科学院阜外医院 2013~2016 年分离铜绿假单胞菌的分布及耐药性分析. 中国循证医学杂志, 2018, 18(5): 450-453. doi: 10.7507/1672-2531.201712006 复制

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