2013-2015年某院痰黏液型铜绿假单胞菌分离和耐药性变迁

目的 了解2013-2015年该院痰黏液型铜绿假单胞菌的分离及耐药性变迁,为临床合理选择抗菌药物提供科学依据.方法 细菌分离、培养和鉴定按照《全国临床检验操作规程》第四版操作,药敏试验采用纸片扩散法(K-B法),以临床实验室标准委员会2014版(CLSI 2014)标准判定药敏试验结果,应用WHONET5.6软件分析试验数据.结果 2013-2015年临床痰液标本中检出铜绿假单胞菌1 653株,其中黏液型铜绿假单胞菌255株,占15.4%;3年平均耐药率最高的抗菌药物为哌拉西林,耐药率为29.0%;耐药率均低于10.0%的抗菌药物有阿米卡星、哌拉西林/他唑巴坦;耐药率增幅较大的抗菌药物为亚胺培南、左氧氟沙星、环丙沙星、头孢他啶,分别由2013年的12.5%、9.7%、8.3%、9.7%上升至2015年的20.5%、17.0%、19.3%、15.9%.结论 2013-2015年间痰黏液型铜绿假单胞菌分离率逐年升高,耐药率近3年呈上升趋势,医院应加强黏液型铜绿假单胞菌耐药性监测.

Isolation and change of drug resistance of mucoid Pseudomonas aeruginosa in sputum from 2013 to 2015 in a hospital

Objective To understand the isolation and change of drug resistance of mucoid Pseudomonas aeruginosa in sputum from 2013 to 2015 so as to provide a scientific basis for reasonable clinical use of antibacterial drugs.Methods The isolation,culture and identification were carried out according to the fourth edition of National Clinical Laboratory Operation Rules.The drug susceptibility testing was performed with the use of Kindy-Bauer.The drug susceptibility testing results were judged according to the standards of CLSI 2014.The clinical data were analyzed by software WHONET 5.6.Results Among 1 653 strains of Pseudomonas aeruginosa isolated in the clinical sputum specimens from 2013 to 2015,including 255(15.4%)strains of mucoid Pseudomonas aeruginosa;during the three years,the drugs of highest drug resistance rate was piperacillin,which was 29.0%;the drug resistance rate less than 10.0% had amikacin and piperacillin/tazobactam;the drugs with larger increase range of resistance rate included imipenem,levofloxacin,ciprofloxacin and ciprofloxacin,their resistance rates were increased from 12.5%,9.7%,8.3% and 9.7% in 2013 to 20.5%,17.0%,19.3% and 15.9% in 2015.Conclusion The isolating rate of mucoid Pseudomonas aeruginosa in sputm is gradually increased year by year from 2013 to 2015.At the same time,the drug resistance rates show an increasing trend in recent three years.It is necessary to strengthen the surveillance of drug resistance of mucoid Pseudomonas aeruginosa.