[1]高世华 池细俤 李国玉 吴文辉.2013—2017年耐碳青霉烯类铜绿假单胞菌感染情况调查及 耐药性变迁[J].福建医药杂志,2018,40(06):35-38.
 GAO Shihua,CHI Xidi,LI Guoyu,et al.Investigation on the prevalence and drug resistance of CRPA from 2013 to 2017[J].FUJIAN MEDICAL JOURNAL,2018,40(06):35-38.
点击复制

2013—2017年耐碳青霉烯类铜绿假单胞菌感染情况调查及 耐药性变迁()
分享到:

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
40
期数:
2018年06期
页码:
35-38
栏目:
临床研究·
出版日期:
2018-11-29

文章信息/Info

Title:
Investigation on the prevalence and drug resistance of CRPA from 2013 to 2017
文章编号:
1002-2600(2018)06-0035-05
作者:
高世华 池细俤 李国玉 吴文辉
福建医科大学附属南平第一医院检验科(南平 353000)
Author(s):
GAO ShihuaCHI Xidi LI Guoyu WU WenHui.
Department of Clinical Laboratory,the First Affiliated First Hospital of Nanping,Fujian Medical University,Nanping, Fujian 353000,China
关键词:
铜绿假单胞菌 碳青霉烯类 构成比 耐药性
Keywords:
pseudomonas aeruginosa carbapenems constituent ratio drug resistance
分类号:
R446.5
文献标志码:
B
摘要:
目的 了解耐碳青霉烯铜绿假单胞菌(CRPA)医院感染特点及耐药性变迁规律,为临床合理用药提供参考。方法 回顾性分析2013—2017年我院CRPA感染者临床资料、细菌检验结果。结果 共检出铜绿假单胞菌(PAE)2 204株(10.31%),其中CRPA 155株(7.03%),CRPA占比5年分别为:10.67%、17.70%、6.70%、4.85%和4.96%; CRPA感染者中男性66.5%; 患者年龄段分布:>60岁57.4%、36~60岁35.5%、15~35岁5.2%、0~14岁1.9%; 科室分布:ICU 28.4%、神经外科27.7%、呼吸内科16.8%; 标本分布:痰82.6%; 创口7.1%; TOB、GEN、CIP、LEV、FEP、CAZ、PIP、TZP 5年中耐药性持续较高水平; AKN 耐药率5年分别为:37.5%、22.5%、8.6%、5.6%、3.6%; 氨基甙类药物间的耐药率比较:AKN 13.55%、TOB 22.43%、GEN 26.62%(χ2=8.324,P=0.016),三、四代头孢菌素间比较:CAZ 31.17%、FEP 30.32%(χ2=0.026,P=0.872),喹诺酮类药物间比较:CIP 36.13%、LEV 42.48%(χ2=1.304,P=0.254),PIC与其酶抑制剂复合药比较:PIC 39.07%、TZP 37.01%(χ2=0.137,P=0.711)。结论 近5年来CRPA构成比有逐年下降趋势。应加强对老年患者等易感人群管理和ICU、神经外科、呼吸内科的院感监测,制定有效的下呼吸道、创口的预防感染方案。AKN是临床治疗CRPA感染的较好选择。
Abstract:
Objective To understand the characteristics of nosocomial infection and drug resistance change of carbapenem resistant pseudomonas aeruginosa(CRPA)to provide reference for clinical rational use of antibiotics.Methods The clinical data and bacterial examination results of CRPA infected patients in a major general hospital in 2013-2017 years were analyzed retrospectively.Results A total of 2204 strains of Pseudomonas aeruginosa(PAE)were detected, forming a ratio of 10.31%; 155 strains of CRPA were detected and the proportion of CRPA/PAE is 7.03%, the proportion of CRPA for 5 years were 10.67%, 17.70%, 6.70%, 4.85% and 4.96%, respectively; 66.5% CRPA infected patients were male; 57.4% cases were >60 years, 35.5% cases were 36-60 years, 5.2% cases were 15-35 years and 1.9% cases were 0-14 years if patients were distributed by age; CRPA. Department Distribution: 28.4% cases were from ICU, 27.7% cases were from department of neurosurgery and 16.8% cases were from respiratory medicine if CRPA patients were distributed by departments; 82.6% specimens were sputum; and 7.1% specimens were from wound. In the past 5 years, drug resistance against TOB, GEN, CIP, LEV, FEP, CAZ, PIP and TZP were maintained at high level. The resistance rates to AKN were 5, 37.5%, 22.5%, 8.6%, 5.6% and 3.6%, respectively, for the past 5 years. Comparison of drug resistance rates among aminoglycosides: AKN 13.55%, TOB 22.43%, GEN 26.62%(χ2=8.324,P=0.016). Comparison between the third and fourth generation cephalosporin: CAZ 31.17%, FEP 30.32%(χ2=0.026,P=0.872), quinolones, CIP 36.13%, LEV 42.48%(χ2=1.304,P=0.254), PIC and enzyme inhibitors: PIC 39.07%, TZP 37.01%(χ2=0.137,P=0.711).Conclusion In the last 5 years, the composition ratio of CRPA has been declining by year. In order to reduce the risk of CRPA infection, it is necessary to strengthen the management of the elderly and other susceptible people, strengthen the monitoring of hospital infection in ICU, department of neurosurgery and respiratory medicine, and establish an effective infection prevention program for the lower respiratory tract and the wound. AKN is a better choice for clinical treatment of CRPA infection.

参考文献/References:

[1] 张祎博,孙景勇,倪语星,等.2005—2014年CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志,2016,16(2):141-145.
[2] 国家卫生计生委合理用药专家委员会,全国细菌耐药监测网.2015年全国细菌耐药监测报告[J].中国执业药师,2016,(3):3-8.
[3] 陈肖华,刘卫.蒋连强,等.某院主要革兰阴性菌分布及耐药性5年动态变化[J].中国感染杂志,2016,15(4):277-280.
[4] 袁莉莉,丁百兴,沈震,等.碳青霉烯类抗生素耐药铜绿假单胞菌感染的临床研究[J].中国感染与化疗杂志,2017,17(2):121-126.
[5] 中华医学会呼吸病学分会感染学组.铜绿假单胞菌下呼吸道感染诊治专家共识[J].中华结核和呼吸杂志,2014,37(1):9-15.
[6] 李进,胡韦维,张峰领,等.重庆某三甲医院2014—2016年铜绿假单胞菌耐药表型及金属酶、外膜孔蛋白耐药基因型分析[J].第三军医大学学报,2017,39(22):2200-2205.
[7] 陆建福,王伟,李华信,等.2012—2015年河南省4所医院铜绿假单胞菌分布及耐药性分析[J].新乡医学院学报,2017,34(11):994-997.
[8] 曾章锐,王卫萍,黄梅,等.临床分离的铜绿假单胞菌对头孢吡肟敏感性低于头孢他啶的机制研究[J].检验医学,2014,29(11):1178-1183.
[9] Lin KY, Lauderdale T L, Wang J T,et al. Carbapenem resistant Pseudomonas aeruginosa in Taiwan:Prevalence,risk factors, and impact on outcome of infections [J].J Microbiol Immunol Infect,2016,49(1):52-59.

相似文献/References:

[1]霍然,李俊毅,陈丽妹,等.2016-2020年肿瘤患者铜绿假单胞菌感染及耐药趋势分析[J].福建医药杂志,2023,45(01):19.
 HUO Ran,LI Junyi,CHEN Limei,et al.Retrospective study of pseudomonas aeruginosa infection and drug resistance in tumor patients from 2016 to 2020[J].FUJIAN MEDICAL JOURNAL,2023,45(06):19.

备注/Memo

备注/Memo:
基金项目:福建省南平市科技计划项目(N2013Y01-1)
更新日期/Last Update: 2018-11-29