本文關(guān)鍵詞：ICU病房與普通病房銅綠假單胞菌耐藥性分析　出處：《西部醫(yī)學(xué)》2017年01期 　論文類型：期刊論文

  更多相關(guān)文章： 銅綠假單胞菌 耐藥性 多重耐藥 重癥監(jiān)護(hù)室 限定日劑量

【摘要】：目的分析ICU病房與普通病房分離的銅綠假單胞菌對抗菌藥物的耐藥性,為臨床治療用藥提供參考。方法采用K-B法進(jìn)行藥敏試驗(yàn),以CLSI 2012年版判斷標(biāo)準(zhǔn)分析臨床分離株的敏感性,分析采用WHONET5.4及SPSSl8.0統(tǒng)計(jì)軟件。結(jié)果 2011年1月~2014年12月共分離出銅綠假單胞菌1275株,其中ICU病房分離出452株,占35.5%;分離的菌株主要來源于呼吸道痰標(biāo)本,占70.1%。ICU中分離的銅綠假單胞菌對阿米卡星的耐藥率最低,為19.0%;對頭孢哌酮的耐藥率最高,為47.3%;對哌拉西林/他唑巴坦、頭孢哌酮/舒巴坦、頭孢他啶、頭孢吡肟的耐藥在21.0%~34.3%之間;對亞胺培南的耐藥率高達(dá)36.3%。普通病房(內(nèi)、外科及其它科)中分離出823株,其對阿米卡星的耐藥率仍然最低,為10.9%;其后由低到高依次為頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、頭孢吡肟、頭孢他啶、亞胺培南、美洛西林、環(huán)丙沙星、慶大霉素、哌拉西林、氨曲南、頭孢哌酮,其耐藥率介于12.5%~39.9%之間。ICU中銅綠假單胞菌對常用抗菌藥物的耐藥性及多重耐藥菌株的檢出率均要顯著高于普通病房,且銅綠假單胞菌對抗菌藥物的耐藥性與相應(yīng)的用藥頻度有關(guān)。結(jié)論 ICU中多重耐藥銅綠假單胞菌耐藥性仍是監(jiān)控重點(diǎn)。通過分析銅綠假單胞菌的耐藥性,有利于指導(dǎo)臨床合理用藥及減緩細(xì)菌耐藥的發(fā)生。
[Abstract]:Objective to analyze the antimicrobial resistance of Pseudomonas aeruginosa isolated from ICU wards and general wards, and to provide a reference for clinical treatment. The sensitivity of clinical isolates was analyzed according to the criteria of CLSI 2012. Results from January 2011 to December 2014, 1275 strains of Pseudomonas aeruginosa were isolated. 452 strains (35. 5%) were isolated from ICU ward. The isolates were mainly isolated from respiratory sputum, accounting for 70.1. The resistance rate of Pseudomonas aeruginosa to amikacin was the lowest (19.0) in ICU. The rate of resistance to cefoperazone was the highest (47.3%). Resistance to piperacillin / tazobactam, cefoperazone / sulbactam, ceftazidime and cefepime was between 21.0% and 34.3%; The resistance rate to imipenem was as high as 36.3%. 823 strains were isolated from general wards (internal, surgical and other departments), and the resistance rate to amikacin was still the lowest (10.9%). Then cefoperazone / sulbactam, piperacillin / tazobactam, cefepime, ceftazidime, imipenem, meloxicillin, ciprofloxacin, gentamicin, piperacillin and aztreonam were followed by the low to high order. The drug resistance rate of cefoperazone was between 12.5% and 39.9%. The resistance of Pseudomonas aeruginosa to common antibiotics and the detection rate of multidrug resistant strains in ICU were significantly higher than those in general wards. The drug resistance of Pseudomonas aeruginosa to antimicrobial agents is related to the frequency of drug use. Conclusion the drug resistance of multidrug resistant Pseudomonas aeruginosa in ICU is still the focus of monitoring. The drug resistance of Pseudomonas aeruginosa is analyzed by analyzing the drug resistance of Pseudomonas aeruginosa. It is helpful to guide rational drug use in clinic and to slow down the occurrence of bacterial drug resistance.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬荊州醫(yī)院感染科;重慶醫(yī)科大學(xué)附屬第一醫(yī)院感染科·重慶市傳染病寄生蟲病學(xué)重點(diǎn)實(shí)驗(yàn)室;
【基金】：人事部科研基金(09958013) 重慶市自然科學(xué)基金(CSTC2009BB5061)
【分類號】：R446.5;R459.7
【正文快照】： 2.重慶醫(yī)科大學(xué)附屬第一醫(yī)院感染科·重慶市傳染病寄生蟲病學(xué)重點(diǎn)實(shí)驗(yàn)室,重慶400016)銅綠假單胞菌是醫(yī)院感染最常見的病原菌,屬條件致病菌,在免疫力低下的患者中可引起嚴(yán)重甚至致死性的感染,如肺部感染、敗血癥、泌尿系感染、腦膜炎等。ICU患者因存在各種致免疫力低下的潛在危

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