上海市某三甲医院2015－2019年铜绿假单胞菌的分布和耐药性分析

目的 分析我院近5年铜绿假单胞菌(PA)的临床分布及其对抗菌药物的耐药性,为临床合理使用抗菌药物和减少耐药菌株以及防控医院感染提供依据。方法 回顾性分析上海长海医院2015-2019年住院患者临床标本分离的PA数据,采用WHONET 5.6和EXCEL等软件对PA和耐碳青霉烯类铜绿假单胞菌(CRPA)的科室分布、标本来源及耐药率等进行统计分析。 结果 本院近5年内住院患者共检出PA 1822株,其中CRPA 550株(占30.2%)。 PA和CRPA检出率最高的科室为烧伤科(16.1%和17.8%),其次为急诊科(13.9%和14.7%)；PA和CRPA的标本主要为呼吸道标本—痰液/支气管肺泡灌洗液(50.3%和61.8%),其次是分泌物(16.5%和10.5%)。14种临床抗菌药物的药敏结果显示, PA和CRPA耐药率最高的是亚胺培南(22.7%和93.4%),其次为美洛培南(20.3%和83.3%)。对CRPA季节分布进行统计分析显示,CRPA秋季检出率最高(28.9%),其次为春季(25.4%)。结论 本院PA和CRPA的检出率较高,应及时了解和分析PA和CRPA的临床分布以及耐药率变化,加强耐药性监测,优化临床用药,有效预防和控制院内感染。

Distribution and drug resistance of Pseudomonas aeruginosa in a tertiary first-class hospital from 2015 to 2019 in Shanghai

: Objective To analyze the clinical distribution and drug resistance of the Pseudomonas aeruginosa (PA) isolated from the hospital during the past 5 years, so as to provide the guidance of antibiotics, reduce drug-resistant strains and strengthen prevention and control of hospital infections. Methods A retrospective analysis was carried out for the PA isolated from clinical specimens of inpatients in the hospital during 2015 to 2019, using software such as WHONET 5.6 and EXCEL to analyze the clinical distribution, specimen sources and drug resistance of PA and carbapenem-resistant Pseudomonas aeruginosa (CRPA). Results A total of 1,822 PAs were detected in the hospital within 5 years, among which 550 CRPAs (30.2%) were detected. The department with the highest detection rate of PA and CRPA is the burn department (16.1% and 17.8%), followed by the emergency department (13.9% and 14.7%); PA and CRPA isolates were mainly from respiratory specimens-sputum/ bronchoalveolar lavage fluid (50.3% and 61.8%), followed by secretions (16.5% and 10.5%). The susceptibility results of 14 clinical antibacterial drugs show that the highest drug resistance rates of PA and CRPA are imipenem (22.7% and 93.4%), followed by meropenem (20.3% and 83.3%). Seasonal statistical analysis of CRPA showed that the highest detection rate of CRPA was in autumn (28.9%), followed by spring (25.4%). Conclusion The prevalence of PA and CRPA in our hospital is high. It is necessary to timely analyze the current clinical distribution and drug resistance changes of PA and CRPA in the hospital,strengthen drug resistance monitoring,optimize clinical rational use of drugs and effectively prevent and control nosocomial infections.