耐碳青霉烯类铜绿假单胞菌分布方式以及耐药性研究
|
摘要
目的研究耐碳青霉烯类铜绿假单胞菌分布方式以及耐药性。方法随机选取2016年6月～2018年6月我院收治的住院患者的铜绿假单胞菌2288株,其中耐碳青霉烯类铜绿假单胞菌60株,占总数的2.6%。进行菌株培养和鉴定、药敏试验,然后分析耐碳青霉烯类铜绿假单胞菌的科室分布及耐药性。结果耐碳青霉烯类铜绿假单胞菌主要分布在重症监护室,占总数的50.0%;其次为神经外科,占总数的26.7%;再次为神经内科,占总数的13.4%;最后为呼吸科、骨科、普外科,均占总数的3.3%。耐碳青霉烯类铜绿假单胞菌对美罗培南、亚胺培南、氨曲南、哌拉西林、左氧氟沙星、庆大霉素的耐药性最高,均为100.0%;其次为妥布霉素、哌拉西林/他唑巴坦,耐药性均为96.7%;再次为头孢吡肟、头孢他啶、头孢哌酮/舒巴坦、环丙沙星,耐药性分别为93.3%、90.0%、90.0%、83.3%,最后为阿米卡星,耐药性为16.7%;对多黏菌素B不耐药,耐药性为0。结论耐碳青霉烯类铜绿假单胞菌分布较为集中,高度耐药于常见抗菌药物,实时监控耐碳青霉烯类铜绿假单胞菌感染患者能够对其在医院内传播进行有效预防。
Objective To study the distribution pattern and drug resistance of carbapenem-resistant Pseudomonas aeruginosa. Methods 2288 strains of Pseudomonas aeruginosa were randomly selected from hospitalized patients admitted to our hospital from June 2016 to June 2018. Among them, there were 60 strains of carbapenem-resistant Pseudomonas aeruginosa, accounting for 2.6% of the total. The strain culture, identification, and drug sensitivity test were carried out, and the department distribution and drug resistance of carbapenem-resistant Pseudomonas aeruginosa were analyzed. Results The carbapenem-resistant Pseudomonas aeruginosa was mainly distributed in the intensive care unit,accounting for 50.0% of the total, followed by the department of neurosurgery, accounting for 26.7% of the total, again followed by the department of neurology, accounting for 13.4% of the total; it was least distributed in the departments of respiratory medicine, orthopedics, and general surgery, accounting for 3.3% of the total. The carbapenem-resistant Pseudomonas aeruginosa showed the highest resistance to meropenem, imipenem, aztreonam, piperacillin, levofloxacin and gentamicin,with the drug resistance of 100.0%, followed by tobramycin, piperacillin/tazobactam, with the drug resistance of 96.7%, again followed by cefepime, ceftazidime,cefoperazone/sulbactam, ciprofloxacin, with the drug resistance of 93.3%, 90.0%, 90.0%, 83.3%, respectively; it showed the least resistance to amikacin, with the drug resistance of 16.7%; it was not resistant to polymyxin B, with the drug resistance of 0. Conclusion The distribution of carbapenem-resistant Pseudomonas aeruginosa is concentrated, which is highly drug resistant to common antibacterial drugs. Realtime monitoring of patients with carbapenem-resistant Pseudomonas aeruginosa infections can effectively prevent their transmission in hospitals.
Objective To study the distribution pattern and drug resistance of carbapenem-resistant Pseudomonas aeruginosa. Methods 2288 strains of Pseudomonas aeruginosa were randomly selected from hospitalized patients admitted to our hospital from June 2016 to June 2018. Among them, there were 60 strains of carbapenem-resistant Pseudomonas aeruginosa, accounting for 2.6% of the total. The strain culture, identification, and drug sensitivity test were carried out, and the department distribution and drug resistance of carbapenem-resistant Pseudomonas aeruginosa were analyzed. Results The carbapenem-resistant Pseudomonas aeruginosa was mainly distributed in the intensive care unit,accounting for 50.0% of the total, followed by the department of neurosurgery, accounting for 26.7% of the total, again followed by the department of neurology, accounting for 13.4% of the total; it was least distributed in the departments of respiratory medicine, orthopedics, and general surgery, accounting for 3.3% of the total. The carbapenem-resistant Pseudomonas aeruginosa showed the highest resistance to meropenem, imipenem, aztreonam, piperacillin, levofloxacin and gentamicin,with the drug resistance of 100.0%, followed by tobramycin, piperacillin/tazobactam, with the drug resistance of 96.7%, again followed by cefepime, ceftazidime,cefoperazone/sulbactam, ciprofloxacin, with the drug resistance of 93.3%, 90.0%, 90.0%, 83.3%, respectively; it showed the least resistance to amikacin, with the drug resistance of 16.7%; it was not resistant to polymyxin B, with the drug resistance of 0. Conclusion The distribution of carbapenem-resistant Pseudomonas aeruginosa is concentrated, which is highly drug resistant to common antibacterial drugs. Realtime monitoring of patients with carbapenem-resistant Pseudomonas aeruginosa infections can effectively prevent their transmission in hospitals.
引文
[1]袁莉莉,丁百兴,沈震,等.耐碳青霉烯类铜绿假单胞菌的耐药性及分子流行病学研究[J].中国感染与化疗杂志,2017,17(3):289-292.
[2]袁翊,叶帮芬,万小涛,等.耐碳青霉烯类铜绿假单胞菌的耐药机制[J].检验医学与临床,2017,14(11):1602-1604.
[3]卢雯君,李健,李情操,等.ICU耐碳青霉烯类铜绿假单胞菌检出及同源性分析[J].浙江临床医学,2017,19(5):957-958.
[4]邸秀珍,王睿.耐碳青霉烯类铜绿假单胞菌耐药机制的研究现状[J].中国临床药理学杂志,2015,31(8):669-672.
[5]袁利,徐羽中,程明刚,等.耐碳青霉烯类铜绿假单胞菌耐药现状及整合子耐药基因分析[J].中国医学装备,2018,15(4):80-83.
[6]李情操,姚芳芳,吴巧萍,等.宁波市某医院耐碳青霉烯类铜绿假单胞菌中第一类整合子的分布及来源[J].上海预防医学,2017,29(7):545-547.
[7]石庆新,吕小萍,於青峰,等.盐酸小檗碱和亚胺培南联合作用耐碳青酶烯类铜绿假单胞菌的体外药敏实验研究[J].中国现代医生,2017,55(1):114-117.
[8]孙景熙,王福斌,陈剑明,等.手外伤感染患者伤口病原菌分布及耐药性分析[J].中国现代医生,2018,56(4):111-115.
[9]Shortridge D,Pfaller MA,Castanheira M,et al.Antimicrobial activity of ceftolozane-tazobactam tested against Enterobacteriaceae and Pseudomonas aeruginosa collected from patients with bloodstream infections isolated in United States hospitals(2013-2015)as part of the Program to Assess Ceftolozane-Tazobactam Susceptibility(PACTS)surveillance program[J].Diagn Microbiol Infect Dis,2018,18(18):30168-30168.
[10]Lim CLL,Chua AQ,Teo JQM,et al.Importance of control groups when delineating antibiotic use as risk factors for carbapenem-resistance,extreme-drug and pan-drug resistance in acinetobacter baumannii and pseudomonas aeruginosa:A systematic review and meta-analysis[J].Int J Infect Dis.2018,2(18)34427-34428.
[11]Karampatakis T,Tsergouli K,Iosifidis E,et al.Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care[J].J Hosp Infect,2018,99(4):396-404.
[12]Yeo CK,Vikhe YS,Li P,et al.Hydrogel effects rapid biofilm debridement with ex situ contact-kill to eliminate multidrug resistant bacteria in vivo[J].ACS Appl Mater Interfaces,2018,10(24):20356-20367.
[13]Kuti JL,Wang Q,Chen H,et al.Defining the potency of amikacin against escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa,and acinetobacter baumannii derived from Chinese hospitals using CLSI and inhalation-based breakpoints[J].Infect Drug Resist,2018,11(10):783-790.
[14]Dogonchi AA,Ghaemi EA,Ardebili A,et al.Metallo-β-lactamase-mediated resistance among clinical carbapenem-resistant Pseudomonas aeruginosa isolates in northern Iran:A potential threat to clinical therapeutics[J].Ci Ji Yi Xue Za Zhi,2018,30(2):90-96.
[15]Fritzenwanker M,Imirzalioglu C,Herold S,et al.Treatment options for carbapenem-resistant gram-negative infections[J].Dtsch Arztebl Int,2018,115(20-21):345-352.
[16]Gofman N,To K,Whitman M,et al.Successful treatment of ventriculitis caused by Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae with i.v.ceftazidime-avibactam and intrathecal amikacin[J].Am JHealth Syst Pharm,2018,75(13):953-957.
[17]Cho HH,Kwon KC,Kim S,et al.Association between biofilm formation and antimicrobial resistance in carbapenem-resistant pseudomonas aeruginosa[J].Ann Clin Lab Sci,2018,48(3):363-368.
[18]Jabalameli F,Taki E,Emaneini M,et al.Prevalence of metallo-β-lactamase-encoding genes among carbapenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Iran[J].Rev Soc Bras Med Trop,2018,51(3):270-276.
[19]Ismail SJ,Mahmoud SS,First detection of New Delhi metallo-β-lactamases variants(NDM-1,NDM-2)among Pseudomonas aeruginosa isolated from Iraqi hospitals[J].Iran J Microbiol,2018,10(2):98-103.
[20]Tang X,Xiao M,Zhuo C,et al.Multi-level analysis of bacteria isolated from inpatients in respiratory departments in China[J].J Thorac Dis,2018,10(5):2666-2675.
[2]袁翊,叶帮芬,万小涛,等.耐碳青霉烯类铜绿假单胞菌的耐药机制[J].检验医学与临床,2017,14(11):1602-1604.
[3]卢雯君,李健,李情操,等.ICU耐碳青霉烯类铜绿假单胞菌检出及同源性分析[J].浙江临床医学,2017,19(5):957-958.
[4]邸秀珍,王睿.耐碳青霉烯类铜绿假单胞菌耐药机制的研究现状[J].中国临床药理学杂志,2015,31(8):669-672.
[5]袁利,徐羽中,程明刚,等.耐碳青霉烯类铜绿假单胞菌耐药现状及整合子耐药基因分析[J].中国医学装备,2018,15(4):80-83.
[6]李情操,姚芳芳,吴巧萍,等.宁波市某医院耐碳青霉烯类铜绿假单胞菌中第一类整合子的分布及来源[J].上海预防医学,2017,29(7):545-547.
[7]石庆新,吕小萍,於青峰,等.盐酸小檗碱和亚胺培南联合作用耐碳青酶烯类铜绿假单胞菌的体外药敏实验研究[J].中国现代医生,2017,55(1):114-117.
[8]孙景熙,王福斌,陈剑明,等.手外伤感染患者伤口病原菌分布及耐药性分析[J].中国现代医生,2018,56(4):111-115.
[9]Shortridge D,Pfaller MA,Castanheira M,et al.Antimicrobial activity of ceftolozane-tazobactam tested against Enterobacteriaceae and Pseudomonas aeruginosa collected from patients with bloodstream infections isolated in United States hospitals(2013-2015)as part of the Program to Assess Ceftolozane-Tazobactam Susceptibility(PACTS)surveillance program[J].Diagn Microbiol Infect Dis,2018,18(18):30168-30168.
[10]Lim CLL,Chua AQ,Teo JQM,et al.Importance of control groups when delineating antibiotic use as risk factors for carbapenem-resistance,extreme-drug and pan-drug resistance in acinetobacter baumannii and pseudomonas aeruginosa:A systematic review and meta-analysis[J].Int J Infect Dis.2018,2(18)34427-34428.
[11]Karampatakis T,Tsergouli K,Iosifidis E,et al.Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care[J].J Hosp Infect,2018,99(4):396-404.
[12]Yeo CK,Vikhe YS,Li P,et al.Hydrogel effects rapid biofilm debridement with ex situ contact-kill to eliminate multidrug resistant bacteria in vivo[J].ACS Appl Mater Interfaces,2018,10(24):20356-20367.
[13]Kuti JL,Wang Q,Chen H,et al.Defining the potency of amikacin against escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa,and acinetobacter baumannii derived from Chinese hospitals using CLSI and inhalation-based breakpoints[J].Infect Drug Resist,2018,11(10):783-790.
[14]Dogonchi AA,Ghaemi EA,Ardebili A,et al.Metallo-β-lactamase-mediated resistance among clinical carbapenem-resistant Pseudomonas aeruginosa isolates in northern Iran:A potential threat to clinical therapeutics[J].Ci Ji Yi Xue Za Zhi,2018,30(2):90-96.
[15]Fritzenwanker M,Imirzalioglu C,Herold S,et al.Treatment options for carbapenem-resistant gram-negative infections[J].Dtsch Arztebl Int,2018,115(20-21):345-352.
[16]Gofman N,To K,Whitman M,et al.Successful treatment of ventriculitis caused by Pseudomonas aeruginosa and carbapenem-resistant Klebsiella pneumoniae with i.v.ceftazidime-avibactam and intrathecal amikacin[J].Am JHealth Syst Pharm,2018,75(13):953-957.
[17]Cho HH,Kwon KC,Kim S,et al.Association between biofilm formation and antimicrobial resistance in carbapenem-resistant pseudomonas aeruginosa[J].Ann Clin Lab Sci,2018,48(3):363-368.
[18]Jabalameli F,Taki E,Emaneini M,et al.Prevalence of metallo-β-lactamase-encoding genes among carbapenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Iran[J].Rev Soc Bras Med Trop,2018,51(3):270-276.
[19]Ismail SJ,Mahmoud SS,First detection of New Delhi metallo-β-lactamases variants(NDM-1,NDM-2)among Pseudomonas aeruginosa isolated from Iraqi hospitals[J].Iran J Microbiol,2018,10(2):98-103.
[20]Tang X,Xiao M,Zhuo C,et al.Multi-level analysis of bacteria isolated from inpatients in respiratory departments in China[J].J Thorac Dis,2018,10(5):2666-2675.