«上一篇/Previous Article|本期目錄/Table of Contents|下一篇/Next Article»

《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:

40

期數(shù):

2018年06期

頁碼:

35-38

欄目:

臨床研究·

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

文章編號:

1002-2600(2018)06-0035-05

作者:

高世華 池細俤 李國玉 吳文輝

福建醫(yī)科大學附屬南平第一醫(yī)院檢驗科(南平 353000)

Author(s):

GAO Shihua; CHI Xidi;  LI Guoyu;  WU WenHui.

Department of Clinical Laboratory,the First Affiliated First Hospital of Nanping,Fujian Medical University,Nanping, Fujian 353000,China

關(guān)鍵詞:

銅綠假單胞菌;  碳青霉烯類;  構(gòu)成比;  耐藥性

Keywords:

pseudomonas aeruginosa;  carbapenems;  constituent ratio;  drug resistance

分類號:

R446.5

文獻標志碼:

B

摘要:

目的 了解耐碳青霉烯銅綠假單胞菌(CRPA)醫(yī)院感染特點及耐藥性變遷規(guī)律,為臨床合理用藥提供參考。方法 回顧性分析2013—2017年我院CRPA感染者臨床資料、細菌檢驗結(jié)果。結(jié)果 共檢出銅綠假單胞菌(PAE)2 204株(10.31%),其中CRPA 155株(7.03%),CRPA占比5年分別為:10.67%、17.70%、6.70%、4.85%和4.96%; CRPA感染者中男性66.5%; 患者年齡段分布:>60歲57.4%、36～60歲35.5%、15～35歲5.2%、0～14歲1.9%; 科室分布:ICU 28.4%、神經(jīng)外科27.7%、呼吸內(nèi)科16.8%; 標本分布:痰82.6%; 創(chuàng)口7.1%; TOB、GEN、CIP、LEV、FEP、CAZ、PIP、TZP 5年中耐藥性持續(xù)較高水平; AKN 耐藥率5年分別為:37.5%、22.5%、8.6%、5.6%、3.6%; 氨基甙類藥物間的耐藥率比較:AKN 13.55%、TOB 22.43%、GEN 26.62%(χ²=8.324,P=0.016),三、四代頭孢菌素間比較:CAZ 31.17%、FEP 30.32%(χ²=0.026,P=0.872),喹諾酮類藥物間比較:CIP 36.13%、LEV 42.48%(χ²=1.304,P=0.254),PIC與其酶抑制劑復(fù)合藥比較:PIC 39.07%、TZP 37.01%(χ²=0.137,P=0.711)。結(jié)論 近5年來CRPA構(gòu)成比有逐年下降趨勢。應(yīng)加強對老年患者等易感人群管理和ICU、神經(jīng)外科、呼吸內(nèi)科的院感監(jiān)測,制定有效的下呼吸道、創(chuàng)口的預(yù)防感染方案。AKN是臨床治療CRPA感染的較好選擇。

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.

備注/Memo

備注/Memo:

基金項目:福建省南平市科技計劃項目(N2013Y01-1)

常用功能

更新日期/Last Update: 2018-11-29