CAJ | 학술논문

目的：调查宁波地区铜绿假单胞菌的临床分布和耐药性，为临床合理使用抗菌药物提供依据。方法连续收集2010年1月至2013年12月宁波大学医学院附属医院、宁波市第一医院、宁波市第九医院从临床样本中分离的铜绿假单胞菌。分析菌株的临床分布，并采用K-B纸片扩散法测定菌株对常用抗菌药物的敏感性。所有数据用WHONET 5．6软件进行统计学分析。结果四年共分离到细菌26544株，其中非重复的铜绿假单胞菌1757株，占病原菌总数的6．6％。1757株铜绿假单胞菌中，622株（35．4％）分离自重症监护病房（ICU），其次为呼吸科322株（18．3％）。痰样本中分离的铜绿假单胞菌最多见（1045／1757，59．5％），其次为尿液及前列腺液（148／1757，8．4％）、肺泡灌洗液（116／1757，6．6％）、伤口及脓液（237／1757，4．6％）等。四年间，铜绿假单胞菌对大多数抗菌药物的耐药率变化不大，菌株对多种抗菌药物的耐药率均较高，但耐碳青霉烯类铜绿假单胞菌（ CRPA）的检出率在四年间呈上升趋势，占当年铜绿假单胞菌总数的比例分别为35.8％、45.8％、44.5％和54．3％。结论铜绿假单胞菌临床分布广，对多种抗菌药物具有耐药性，CRPA检出率高，应加强监测。
목적：조사저파지구동록가단포균적림상분포화내약성，위림상합리사용항균약물제공의거。방법련속수집2010년1월지2013년12월저파대학의학원부속의원、저파시제일의원、저파시제구의원종림상양본중분리적동록가단포균。분석균주적림상분포，병채용K-B지편확산법측정균주대상용항균약물적민감성。소유수거용WHONET 5．6연건진행통계학분석。결과사년공분리도세균26544주，기중비중복적동록가단포균1757주，점병원균총수적6．6％。1757주동록가단포균중，622주（35．4％）분리자중증감호병방（ICU），기차위호흡과322주（18．3％）。담양본중분리적동록가단포균최다견（1045／1757，59．5％），기차위뇨액급전렬선액（148／1757，8．4％）、폐포관세액（116／1757，6．6％）、상구급농액（237／1757，4．6％）등。사년간，동록가단포균대대다수항균약물적내약솔변화불대，균주대다충항균약물적내약솔균교고，단내탄청매희류동록가단포균（ CRPA）적검출솔재사년간정상승추세，점당년동록가단포균총수적비례분별위35.8％、45.8％、44.5％화54．3％。결론동록가단포균림상분포엄，대다충항균약물구유내약성，CRPA검출솔고，응가강감측。
Objective To investigate the clinical distribution and drug resistance of Pseudomonas aeruginosa in Ningbo area .Methods Pseudomonas aeruginosa strains isolated from the Affiliated Hospital of Ningbo University School of Medicine , Ningbo First Hospital , and Ningbo Ninth Hospital during January 2010 and December 2013 were collected .The clinical distribution of the strains was analyzed , and the antimicrobial susceptibility was determined with Kirby-Bauer method.WHONET 5.6 software was used for data analysis.Results A total of 1 757 Pseudomonas aeruginosa strains were collected in 4 years, accounts for 6.6% (1 757/26 544) of total bacterial strains isolated.Among 1 757 strains, 622 (35.4%) were isolated from intensive care unit ( ICU), and 322 (18.3%) from respiratory department.Most strains (1 045/1 757, 59.5%) were isolated from sputum specimens , followed by urine and succus prostaticus (148/1 757, 8.4%), bronchoalveolar lavage fluid (116/1 757, 6.6%), pus and wound secretion (237/1 757, 4.6%) .Strains were highly resistant to most commonly used antibiotics , and the resistance remained steady during four years.While the positive rates of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were increased, which were 35.8%,45.8%,44.5% and 54.3% in each year.Conclusion Pseudomonas aeruginosa presents a wide clinical distribution and high resistance to multiple antibiotics in Ningbo area .