某院铜绿假单胞菌获得性肺炎病原菌分析及院感防控

目的 了解我院铜绿假单胞菌获得性肺炎患者病原菌的分布及耐药情况。方法 选取2016年7月至2017年12月我院送检的获得性肺炎患者痰液培养标本，采用VITEK2-COMPACT全自动微生物分析仪进行菌株鉴定和药敏分析。结果 总共检出358株铜绿假单胞菌，主要分布于呼吸内科和ICU。患者主要基础疾病为慢性阻塞性肺疾病、慢性支气管炎、脑梗死、脑出血等。检出的铜绿假单胞菌对复方新诺明耐药率最高，对阿米卡星耐药率最低。铜绿假单胞菌耐药率由低到高依次为妥布霉素、哌拉西林/他唑巴坦、庆大霉素、头孢他啶、头孢哌酮/舒巴坦、头孢唑肟钠、头孢曲松钠、亚胺培南和左氧氟沙星。结论 我院需要加强对碳青霉烯类和含β-内酰胺酶抑制剂药物的管控，减少这些药物的使用强度，各临床科室尤其是呼吸内科和ICU需及时监控铜绿假单胞菌的耐药情况，合理使用抗生素，从而逐步降低病原菌耐药状况。

Pathogenic bacteria analysis and prevention in patients with Pseudomonas aeruginosa-associated acquired pneumonia

Objective To understand the distribution and drug resistance of the pathogen in patients with Pseudomonas aeruginosa-associated acquired pneumonia. Methods Sputum specimens were collected from the patients with Pseudomonas aeruginosa-associated acquired pneumonia in our hospital from July 2016 to December 2017 and detected by using VITEK2-COMPACT automatic microbiological analyzer for strain identification and drug sensitivity analysis. Results A total of 358 strains of Pseudomonas aeruginosa were isolated, which mainly came from the departments of respiratory medicine and ICU. The main basic diseases of the patients are chronic obstructive pulmonary disease, chronic bronchitis, cerebral infarction and cerebral hemorrhage. The Pseudomonas aeruginosa had the highest resistance rate to compound Sulfamethoxazole and the lowest resistance rate to Amikacin. The drug resistance rate of Pseudomonas aeruginosa was from low to high, followed by Tobramycin, Piperacillin/Tazobactam, Gentamicin, Ceftazidime, Cefoperazone/Sulbactam, Ceftizoxime sodium, Ceftriaxone sodium, Imipenem and Levofloxacin.Conclusion We need to strengthen the control of use of Carbapenems and β-lactamase inhibitors. All clinical departments, especially respiratory medicine and ICU, should closely monitor the resistance of Pseudomonas aeruginosa.