某三甲医院2015—2018年铜绿假单胞菌感染的耐药性监测

目的 了解十堰市人民医院铜绿假单胞菌的感染率、临床分布及耐药情况，以便更好地指导医院感染的控制以及临床合理运用抗生素。方法 对我院2015年1月1日—2018年12月31日送检标本中分离的1345株铜绿假单胞菌应用VITEK-2鉴定仪进行细菌鉴定，采用KB纸片法进行药敏分析，采用WHONET 5.6软件进行数据统计。结果 共分离出铜绿假单胞菌1345株，主要标本来源为痰液，共检出761株(56.6%)。科室分布主要集中于呼吸内科和重症监护室。与2015年相比，2016—2018年铜绿假单胞菌的检出率、多重耐药率均呈现逐年上升趋势(P<0.05)，不同种类抗生素以头孢菌素类及其酶抑制剂耐药率最高，且增加趋势最显著(P<0.05)。结论 铜绿假单胞菌的临床检出率、多重耐药率逐年增加，耐药现象严重，应加强对临床使用抗生素的监控及干预，减少耐药菌株的产生。

Surveillance of drug resistance of Pseudomonas aeruginosa infections #br# in a top three hospital from 2015 to 2018

Objective To study the infection rate, clinical distribution and drug resistance of Pseudomonas aeruginosa in Shiyan City People's Hospital, so as to better guide the control of nosocomial infections and the rational use of antibiotics. Methods A total of 1,345 strains of Pseudomonas aeruginosa isolated from the samples from January 1, 2015 to December 31, 2018 were used for bacterial identification and drug susceptibility analysis using WHONET 5.6. The software performs data statistics. Results A total of 1,345 Pseudomonas aeruginosa strains were isolated. The main source of the specimen was sputum, and a total of 761 strains (56.6%) were detected. Departmental distribution was mainly concentrated in respiratory medicine and intensive care units. Compared with 2015, the detection rate and multi-drug resistance rate in our hospital from 2016 to 2018 showed an increasing trend year by year (P<0.05). The resistance rate of cephalosporins and their enzyme inhibitors was the highest, and the increasing trend was the most significant (P<0.05). Conclusion The clinical detection rate and multi-drug resistance rate of Pseudomonas aeruginosa are increasing year by year, and the drug resistance is serious. The monitoring and intervention of clinical antibiotics should be strengthened to reduce the production of drug-resistant strains.