186株铜绿假单胞菌的临床分布和耐药性分析

目的分析大连市友谊医院2020年铜绿假单胞菌的临床分布及耐药性,以期为临床诊断和用药提供理论依据。方法收集大连市友谊医院2020年1月—2020年12月铜绿假单胞菌共186株,进行体外细菌培养、鉴定和药敏实验,用WHONET5.6分析药敏情况,用SPSS19.0 软件对痰标本和其它标本来源菌株的耐药率进行比较。结果检出的186株铜绿假单胞菌中有109株来源于痰液,占比58.6%,30株来源于支气管肺泡灌洗液,占比16.1%;分布最广的科室为重症医学科,有59株,占比31.7%,其次为老年病区,有42株,占比22.6%。2020年铜绿假单胞菌对氨基糖苷类抗生素、喹诺酮类抗生素和头孢菌素类抗生素的耐药性较高,对亚胺培南的耐药率最高,高达33.9%,美罗培南的耐药率紧跟其后,为32.3%。痰标本和其它标本的菌株耐药率进行卡方检验,妥布霉素(P=0.044,χ²=4.047)和环丙沙星(P=0.047,χ²=3.947)具有统计学差异。结论随着铜绿假单胞菌耐药性的不断攀升,临床上应该有针对性的合理用药,延缓耐药株的产生。

Analysis of Clinical Distribution and Drug Resistance of 186 Pseudomonas aeruginosa Strains

Objective This paper analyzes the clinical distribution and drug resistance of Pseudomonas aeruginosa from January 2020 to December 2020 at Dalian Friendship Hospital with a view to providing theoretical basis for clinicians’ clinical diagnosis and medication of patients infected with Pseudomonas aeruginosa.Methods A total of 186 strains of Pseudomonas aeruginosa were collected from Friendship Hospital of Dalian in January 2020 and December 2020.In Vitro bacterial culture,identification and drug sensitivity test were conducted.Drug sensitivity was analyzed by WHONET5.6,SPSS19.0 software was used to compare the drug resistance rate between sputum specimens and other specimens.Results In 2020,109 strains were from sputum,accounting for 58.6%,and 30 strains were from bronchoalveolar lavage fluid,accounting for 16.1%.The most widely distributed department is the Department of Critical Care Medicine,with 59 strains,accounting for 31.7%,followed by the Geriatric Ward,with 42 strains,accounting for 22.6%.Pseudomonas aeruginosa was mainly resistant to β-lactam antibiotics,aminoglycoside antibiotics,fluoroquinolones/quinolones and cephalosporins,among which Imipenem had the highest average resistance rate of 33.9%,followed by Meropenem with an average resistance rate of 32.3%.The drug resistance rate of strains in sputum and other specimens was statistically different between Tobramycin (P=0.044,χ²=4.047) and Ciprofloxacin (P=0.047,χ²=3.947).Conclusion With the increasing drug resistance of Pseudomonas aeruginosa,targeted and rational drug use should be carried out in clinic to delay the production of drug-resistant strains.