2016-2018年清镇市第一人民医院铜绿假单胞菌的分布及耐药性分析

目的 探讨2016-2018年清镇市第一人民医院铜绿假单胞菌感染的临床分布特征及耐药性变迁，为临床合理选用抗生素治疗提供参考。方法 收集2016-2018年清镇市第一人民医院临床标本中铜绿假单胞菌的检出情况、病区分布、标本来源及药敏结果等资料，并进行统计分析。结果 共分离出铜绿假单胞菌215株，以痰液标本来源为主，占84.2%，感染病区以呼吸内科、ICU和神经外科占前3位，分别占33.9%、18.1%、17.7%。铜绿假单胞菌对复方新诺明、氨苄西林、头孢唑林、氨苄西林/舒巴坦和头孢曲松的耐药率在90.0%以上，对阿米卡星的耐药率最低。与2016年相比较，2018年铜绿假单胞菌对哌拉西林、头孢他啶、哌拉西林/他唑巴坦、头孢吡肟的耐药率呈下降趋势，对庆大霉素、妥布霉素、阿米卡星、环丙沙星、左氧氟沙星、亚胺培南的耐药率呈上升趋势。结论 2016-2018年铜绿假单胞菌对多种抗生素耐药呈上升趋势，临床应加强铜绿假单胞菌感染监控及耐药性监测，密切关注耐药性变迁，合理选用抗生素治疗。

Analysis on distribution and drug resistance of Pseudomonas aeruginosa in the First People's Hospital of Qingzhen from 2016 to 2018

Objective To investigate the clinical distribution characteristics and drug resistance changes of Pseudomonas aeruginosa infection in the First People''s Hospital of Qingzhen from 2016 to 2018, and provide reference for clinical rational use of antibiotics. Methods The detection, distribution of wards, source of samples, and results of drug susceptibility data of P. aeruginosa in the clinical specimens of the First People''s Hospital of Qingzhen from 2016 to 2018 were collected and statistically analyzed. Results A total of 215 strains of P. aeruginosa were isolated, accounting for 84.2% of the sputum samples. Department of Respiratory Medicine, ICU and Department of Neurosurgery accounted for the top three, accounting for 33.9%, 18.1%, and 17.7%, respectively. The resistance rates of P. aeruginosa to compound sulfamethoxazole, ampicillin, cefazolin, ampicillin/sulbactam and ceftriaxone were above 90.0%, and the resistance rate to amikacin was the lowest. Compared with 2016, the resistance rate of P. aeruginosa to piperacillin, ceftazidime, piperacillin/tazobactam, and cefepime decreased in 2018, compared with gentamicin and tobramycin. The resistance rates of P. aeruginosa to amikacin, ciprofloxacin, levofloxacin and imipenem increased. Conclusion The resistance of P. aeruginosa to various antibiotics is on the rise from 2016 to 2018. The monitoring and drug resistance monitoring of P. aeruginosa infection should be strengthened in clinical practice, and drug resistance changes should be closely monitored. Antibiotic treatment should be used reasonably.