儿童ICU与普通病房铜绿假单胞菌分布及耐药性分析

目的了解铜绿假单胞菌在儿童重症监护病房（ICU）与普通病房的分布及耐药性差异,为临床合理、有效的治疗提供依据。方法分析重庆医科大学附属儿童医院2013年1月至2013年12月ICU及普通病房铜绿假单胞菌培养阳性患儿的年龄分布、菌株来源、抗菌药物的耐药性。结果 ICU和普通病房分别分离出82株和429株铜绿假单胞菌,年龄均小于2岁（70.73%和69.23%）,以痰标本来源（80.49%和64.80%）为主。ICU分离的铜绿假单胞菌对氟喹诺酮类药物的耐药率低于普通病房,对其余测试药物的耐药率均高于普通病房。ICU分离的铜绿假单胞菌中多重耐药菌55株（67.07%）,泛耐药菌44株（53.66%）,均明显高于普通病房（26.81%,3.26%）（P〈0.05）。结论铜绿假单胞菌是ICU常见的病原菌,具有多重耐药特性,加强耐药性监测,控制医院内感染,对临床医生选用有效的抗生素具有十分重要的意义。

Distribution and drug-resistance of Pseudomonas aeruginosa in pediatric intensive care unit vs. non-ICU wards

Objective To investigate the distribution and drug resistance of Pseudomonas aeruginosa in pediatric intensive care unit（ ICU） vs. non-ICU wards,and provide reference for rational use of antimicrobials and effective therapy. Methods The age distribution,source of strains and drug resistance of Pseudomonas aeruginosa in ICU vs.non-ICU wards from Jan. 2013 to Dec. 2013 were analyzed. Results 82 patients in ICU and 429 patients in nonICU wards were Pseudomonas aeruginosa positive,of whom 70. 73% vs. 69. 23% were less than 2 years old. The most common source was sputum（ 80. 49% vs. 64. 80%）. The antimicrobial resistance of Pseudomonas aeruginosa in ICU was higher than that in non-ICU wards except to fluoroquinolones. Multidrug-resistant and pandrug-resistant Pseudomonas aeruginosa isolated from ICU（ 67. 07%,53. 66%） were significantly more than from non-ICU wards（ P 〈0.05）. Conclusion Pseudomonas aeruginosa is a common pathogen in ICU and usually multidrug-resistant. It is improtant to strengthen the monitor of drug resistance and control of hospital-acquired infection.