我院铜绿假单胞菌感染相关因素及耐药性分析

目的了解2011-2012年我院铜绿假单胞菌感染相关因素及耐药性，指导临床合理使用抗生素。方法对我院2011-2012年分离的1070株铜绿假单胞菌，按常规方法进行菌株鉴定、药敏试验，并进行数据分析。结果912例住院患者平均年龄78．4岁，主要分布在ICU（29．6％）、急诊观察室（25．1％）、呼吸内科（16．0％）、老年科（9．6％）和神经内科（6．4％），基础疾病以肺部基础疾病（55．4％）、糖尿病（37．8％）、心血管疾病（29．1％）、脑血管意外（23．6％）、恶性肿瘤（10．3％）多见，其中41．1％的患者近期曾行有创治疗或检查。铜绿假单胞菌对于常见的抗菌药物如头孢他啶、左氧氟沙星甚至亚胺培南等亦有较高的耐药性（达17％～25．6％）；对本院使用相对较少的氨基糖苷类抗生素相对敏感，尤其是阿米卡星（耐药率仅为6．4％）。结论我院铜绿假单胞菌存在较高的耐药性，多数患者存在高龄、伴随基础疾病及曾行有创治疗或检查等相关因素。

Risk factors and drug resistance ofPseudomonas aeruginosa infections in our hospital

Objective To investigate the risk factors and drug resistance of Pseudomonas aeruginosa infections in our hospital. Methods Pseudomonas aeruginosa isolated in our hospital from 2011 to 2012 was conducted to species identification and drug susceptibility test as the routine by France Bio Merieux ATB automatic analyzer. Results A total of 1 070 strains of Pseudomonas aeruginosa were isolated from 912 patients. Average age of the patients was 78.4 years old. The patients were mainly from intensive care unit （29.6%）, emergency observation nursing unit （25.1%）, department of respiratory （16.0%） geriatric department （9.6%） and department of neurology （6.4%）. Common underlying diseases were pulmonary diseases （55.4%）, diabetes （37. 8%）, cardiovascular diseases （29.1%）, diseases of nervous system （23.6%）, and malignant tumors （10.3%）. 41.1% of the patients had accepted invasive operations. Drug resistance of Pseudomonas aeruginosa was serious. The rate of resistance to ceftazidime, levofloxacin and imipenem was 23.6%, 25.6%, and 25.4% respectively. The rate of resistance to amikacin was only 6.4%. Conclusion In our hospital the patient＇s age, underlying systemic diseases, and invasive operations may be the risk factors of Pseudomonas aeruginosa infection caused by drug resistance.