489株铜绿假单胞菌的感染分布和耐药监测

目的了解广东药学院附属第一医院2008～2010年铜绿假单胞菌的感染分布和耐药率变迁,为指导临床合理规范应用抗生素提供依据,使临床治疗更及时、有效。方法对2008年1月至2010年12月该院分离出的铜绿假单胞菌进行体外药敏试验,运用WHONET 5.4软件对药敏结果进行统计学分析。结果铜绿假单胞菌的感染以下呼吸道感染最常见68.9%（337/489）,其次为伤口分泌物11%（54/489）,紧跟其后的是尿液标本7.8%（38/489）和血液标本3.9%（19/489）;从病区分布来看,感染占前5位的是重症监护病房（15.1%）、外科（13.9%）、干保科（11.4%）、呼吸科（6.7%）和肿瘤科（6.3%）;近3年铜绿假单胞菌对12种常用抗生素的耐药率均有不同程度的下降,但耐药率仍维持在较高水平。结论铜绿假单胞菌一直以来都是院内感染常见菌,防止耐药菌的传播,延长抗生素使用寿命,既要加强对细菌耐药的监测力度,及时总结细菌的耐药趋势;也要呼吁临床医生按规范积极送检感染标本,规范临床抗生素的使用。

Infection distribution and drug resistance monitoring in 489 strains of pseudomonas aeruginosa

Objective To understand the infection distribution and change of drug resistance rates in pseudomonas（P.） aeruginosa from 2008 to 2010 in our hospital to provide basis for guidance of rational and standardized antibiotics use in clinic.Methods The strains of P.aeruginosa isolated from our hospital from January 2008 to December 2010 were performed the drug sensitivity in vitro test.The results were statistically analyzed by Whonet 5.4 software.Results P.aeruginosa infections were most common in respiratory tract（68.9%,337/489）,followed by wound secretion（11%,54/489）,urine samples（7.8%,38/489） and blood samples（3.9%,19/489）.In the distribution of disease areas,the top five places of P.aeruginosa infection were ICU wards（15.1%）,surgery wards（13.9%）,cadre care wards（11.4 %）,respiration wards（6.7%） and tumor wards（6.3%）.For recent 3 years,the resistant rates of P.aeruginosa to 12 kinds of common anibiotics were reduced to some degrees,the drug resistance rate remained at high level.Conclusion P.aeruginosa is still a common pathogen in nosocomial infection.Preventing the spread of antibiotic resistant bacteria and extending the service life of antimicrobial drugs,we must strengthen the monitoring intensity of bacterial resistance and summarize the bacterial resistance trend in time,also call on clinical doctors should send the detecting samples according to standardization and standardize antibiotics use in clinic.