91株恶臭假单胞菌流行病学特征及耐药性

目的分析临床分离恶臭假单胞菌的流行病学与耐药特点,为临床合理防治其感染提供依据。方法收集2010年1月—2015年12月临床分离的恶臭假单胞菌及其感染者临床资料,以美国临床实验室标准化协会中的K-B纸片扩散法、药敏判断标准进行药物敏感性试验及其结果判断,以WHONET5.5软件对分离菌株药敏结果进行统计分析。结果临床标本共分离出91株恶臭假单胞菌,以60岁以上老年患者为主(占70.33%);基础疾病以社区获得性肺炎检出最多(占23.08%),其次慢性肺原性心脏病(占15.38%);标本主要来源于深部痰(占57.14%),其次为中段尿(占27.47%);主要分布于呼吸内科(占28.57%),其次为心血管内科(占13.19%)。除对氨曲南耐药率(52.75%)较高外,对庆大霉素、亚胺培南、左氧氟沙星、头孢他啶、美罗培南、环丙沙星等耐药率较低,分别为7.78%、9.89%、2.20%、9.89%、7.69%、2.22%,对阿米卡星和多粘菌素的耐药率均为0。结论恶臭假单胞菌感染主要发生于伴有基础疾病的老年患者,以呼吸道感染为主,对多数抗菌药物的耐药率10%。

Epidemiological characteristics and antimicrobial resistance of 91 strains of Pseudomonas putida

ObjectiveTo analyze the epidemiological characteristics and antimicrobial resistance of clinically isolated Pseudomonas putida(P. putida), and provide basis for rational prevention and treatment of P. putida infection. MethodsP. putida isolated between January 2010 and December 2015, as well as clinical data of patients infected with P. putida were collected, antimicrobial susceptibility of isolates was determined by Kirby Bauer disk diffusion susceptibility testing of Clinical and Laboratory Standards Institute (CLSI) of America, susceptibility testing results of isolated strains were analyzed by WHONET 5.5 software. ResultsA total of 91 strains of P. putida were isolated from clinical specimens, most were from elderly patients aged >60 years(70.33%); the major underlying disease was community acquired pneumonia (23.08%)，followed by chronic pulmonary heart disease(15.38%); the main specimen was sputum(57.14%), followed by urine(27.47%); P. putida mainly distributed in department of respiratory medicine (28.57%), followed by department of cardiovascular medicine (13.19%). P. putida had high resistance rate to aztreonam (52.75%), while resistance rates to gentamicin, imipenem, levofloxacin, ceftazidime, meropenem, and ciprofloxacin were 7.78%, 9.89%, 2.20%, 9.89%, 7.69%, and 2.22% respectively, resistance rates to amikacin and polymyxin were both 0. ConclusionP. putida infection mainly occurs in elderly patients with underlying diseases, mainly respiratory tract infection, resistance rates to most antimicrobial agents were <10%.