临床分离铜绿假单胞菌分布及耐药性监测

目的 分析铜绿假单胞菌临床分离株的分布及对常见药物的耐药状况,并对耐碳青霉烯铜绿假单胞菌采取有效控制措施。方法 采用法国生物梅里埃Vitek 2 compact全自动微生物鉴定及药敏分析系统进行鉴定与药敏试验,参照美国临床和实验室标准协会(CLSI)2014版标准判读结果, 数据分析采用WHONE5.6软件。碳青霉烯酶的检测用Carba NP试验。结果 2014年我院各类标本中共分离出铜绿假单胞菌893株,主要来自下呼吸道痰液标本,占81.5%;阿米卡星耐药率最低为11.6％,其次为哌拉西林/他唑巴坦(21.8%)和左氧氟沙星(21.9%),其中氨曲南耐药率最高为40.4%。结论 我院铜绿假单胞菌主要分离于下呼吸道痰液标本,耐碳青霉烯类的菌株主要来自呼吸内科、ICU和神经外科病房,碳青霉烯酶以VIM型为主。临床应合理使用抗菌药物,同时加强对耐碳青霉烯铜绿假单胞菌感染的监控与管理。

Distribution and antimicrobial resistance surveillance of Pseudomonas aeruginosa isolates

Objective To investigate the distribution and antimicrobial resistance of Pseudomonas aeruginosa isolated from clinical specimens and to make an effective control measure for carbapenem resistant P.aeruginosa.Methods Bacteria identification and drug sensitivity analysis were detected by VITEK 2 compact system (French bioMerieux), the result interpretation was according to the standard of CLSI 2014, and data were analyzed using WHONE5.6 software. Carbapenemases were determined using Carba NP test.Results There were 893 strains of P. aeruginosa isolated from all kinds of clinical samples in our hospital in 2014. Among them, mainly from the lower respiratory tract specimens (81.5%).The drug resistance of P. aeruginosa to Amikacin was the lowest (11.6%), followed by Piperacillin tazobactam and Levofloxacin, respectively 21.8% and 21.9%, the highest was Aztreonam (40.4%).Conclusion P. aeruginosa isolates were mainly form respiratory tract sputum specimens, Carbapenem resistant isolates were mainly from Department of respiratory medicine, ICU and Neurosurgery. Carbapenemases was mainly the Ambler class B metallo-β-lactamases (MBLs) of the VIM type. The use of antimicrobial agents should be reasonable in clinic and the monitoring of P. aeruginosa nosocomial infection should be strengthened.