2016-2018年临床分离铜绿假单胞菌的耐药情况分析
|
摘要
目的分析2016年至2018年湖南省脑科医院铜绿假单胞菌的临床分布情况、耐药情况以及耐药菌株Ⅰ类整合子基因。方法选取湖南省脑科医院2016年1月1日至2018年12月31日临床送检各类标本中分离出795株铜绿假单胞菌作为分析对象,就铜绿假单胞菌的临床分布情况以及耐药情况统计分析,2018年ICU分离的13株多重耐药菌株采用PCR扩增检测Ⅰ类整合子。结果铜绿假单胞菌分布科室主要为神经外科(24.53%),其次为呼吸内科(22.26%)和重症医学科(13.21%);铜绿假单胞菌对临床常用的20种抗生素耐药率和敏感率0-100%不等,多重耐药呈上升趋势;13株多重耐药菌株6株Ⅰ类整合子阳性。结论及时统计细菌分布情况、药物的耐药率、敏感率,并对其进行分析,可以为临床合理用药提供依据,有效预防和控制感染。
Objective To analyze the clinical distribution, drug-resistance and class I integron genes of drug-resistant strains of pseudomonas aeruginosa(PA) in the Brain Hospital of Hunan Province from 2016 to 2018. Methods A total of 795 PA separated from clinical specimens submitted for examination samples in the Brain Hospital of Hunan Province from January 1,2016 to December 31, 2018 were regarded as analysis objects. The clinical distribution and drug-resistance of PA were statistically analyzed. In 2018, class I integron of 13 multiple drug-resistant strains separated from specimens submitted by ICU were detected by PCR amplification. Results Most of PA was from neurosurgery department(24.53%), followed by the department of respiratory medicine(22.26%) and the department of critical care medicine(13.21%). The drug-resistance rate and susceptibility rate of PA to 20 antibiotics commonly used in clinic ranged from 0-100%, with multiple drug-resistance on the rise. The class I integrons were detected positive in 6 of the 13 multiple drug-resistant strains. Conclusion Timely statistics and analysis of bacterial distribution, drug-resistance rate and susceptibility rate could provide the basis for rational drug use in clinics and effectively prevent and control infection.
Objective To analyze the clinical distribution, drug-resistance and class I integron genes of drug-resistant strains of pseudomonas aeruginosa(PA) in the Brain Hospital of Hunan Province from 2016 to 2018. Methods A total of 795 PA separated from clinical specimens submitted for examination samples in the Brain Hospital of Hunan Province from January 1,2016 to December 31, 2018 were regarded as analysis objects. The clinical distribution and drug-resistance of PA were statistically analyzed. In 2018, class I integron of 13 multiple drug-resistant strains separated from specimens submitted by ICU were detected by PCR amplification. Results Most of PA was from neurosurgery department(24.53%), followed by the department of respiratory medicine(22.26%) and the department of critical care medicine(13.21%). The drug-resistance rate and susceptibility rate of PA to 20 antibiotics commonly used in clinic ranged from 0-100%, with multiple drug-resistance on the rise. The class I integrons were detected positive in 6 of the 13 multiple drug-resistant strains. Conclusion Timely statistics and analysis of bacterial distribution, drug-resistance rate and susceptibility rate could provide the basis for rational drug use in clinics and effectively prevent and control infection.
引文
[1]倪语星,尚红.临床微生物学检验[M].5版.北京:人民卫生出版社,2012:137.
[2] GHOLAMI S, TABATABAEI M, SOHRABI N. Comparison of bifilm formation and antibiotic resistance pattern of Pseudomonas aeruginosa in human and environmental islates[J]. Microb Psthog,2017,109:94-98.
[3]刘欢乐,陈舒影,吴小乐.耐亚胺培南铜绿假单胞菌的检出率与耐药性分析[J].中华医院感染学杂志,2016,26(2):265-267.
[4]卢玲玲,潘晓微,潘晓夫.铜绿假单胞菌整合子介导耐药机制的初步研究[J].中国抗生素杂志,2014,39(6):462-465.
[5]谷存国,周伟,王兴红,等.多重耐药铜绿假单胞菌Ⅰ类整合子基因盒的检测与耐药机制研究[J].现代预防医学,2014,41(14):2601-2603.
[6]杨明,钱扬会,赵强元,2013-2015年临床分离铜绿假单胞菌耐药性及Ⅰ类整合子变化分析[J].国际检验医学杂志,2017,38(7):886-889.
[7]中华人民共和国卫生部医政司.全国临床检验操作规程[M].南京:东南大学出版社,2006:770.
[8]向万忠,任碧琼.铜绿假单胞菌的耐药性变迁及耐药机制[J].国际检验医学杂志,2013,34(10):1323-1324.
[9] KIM H S, PARK B K, KIM S K, et al. Clinical characteristics and outcomes of Pseudomonas aeruginosa bactermia in febtile neutropenic children and adolescents with the impact of antibiotic resistance:a retrospective sdudy[J]. BMC Infections Diseases, 2017,17(1):500.
[10]辛力华,周昕,张爽,等.2008-2009年医院感染铜绿假单胞菌的耐药分析[J].中华医院感染学杂志,2012,7(22):1477-1479.
[11]吴晓勇,史俊敏,伍贤鼎.385株铜绿假单胞菌临床分布与耐药性分析[J].检验医学与临床.2013,10(1):126-127.
[12]张艳芳,冯广满.中山地区铜绿假单胞菌耐药性及亚胺培南耐药机制分析[J].南昌大学学报(医学版),2018,58(21):21-22.
[13]陈约慧,应芙蓉,詹玲玲,等.1543株铜绿假单胞菌感染的临床分布与耐药性分析[J].中国临床药理学杂志,2016,34(24):2814-2817.
[14]林丽容.铜绿假单胞菌分布及耐药情况分析[J].临床合理用药,2018,11(12):112-113.
[15]黄兴富,范华.铜绿假单胞菌的临床分布及对环丙沙星耐药机制的研究[J].中国实验诊断学,2014,18(3):437-440.
[16]方平安,熊域皎,鲍永强,等.836株铜绿假单胞菌的临床分布及耐药性分析[J].实用医院临床杂志,2018,15(5):201-204.
[17]张泳,林丽英.住院患者铜绿假单胞菌感染分布、耐药状况及预后影响因素[J].检验医学与临床,2018,15(24):3786-3787.
[18] STOVER C K, PHAM X Q, ERWIN A L, et al. Complete genome sequence of Pseudomonas aeruginosa PAO1, an opportunistic pathogen[J]. Nature, 2000,406(6799):959-964.
[19]郭良,肖秀飞,左娟,等.多重耐药铜绿假单胞菌院内感染的耐药性研究[J].中外医疗,2017,31:185-187.
[20]姜习新.多重耐药的铜绿假单胞菌Ⅰ类整合子与其多重耐药基因的相关性分析[J].检验医学与临床,2012,9(3):300-302.
[21] GAUR A, PRAKASH P, ANUPURBA S, et al. Possible role of integrase gene polymerase chain reaction as an epidemilolgical marker:study of multidrug-resistant acinetobacter baumannii isolated from nosocomial infections[J]. International Journal of Antimicrobial Agents, 2007,29(4):446-450.
[2] GHOLAMI S, TABATABAEI M, SOHRABI N. Comparison of bifilm formation and antibiotic resistance pattern of Pseudomonas aeruginosa in human and environmental islates[J]. Microb Psthog,2017,109:94-98.
[3]刘欢乐,陈舒影,吴小乐.耐亚胺培南铜绿假单胞菌的检出率与耐药性分析[J].中华医院感染学杂志,2016,26(2):265-267.
[4]卢玲玲,潘晓微,潘晓夫.铜绿假单胞菌整合子介导耐药机制的初步研究[J].中国抗生素杂志,2014,39(6):462-465.
[5]谷存国,周伟,王兴红,等.多重耐药铜绿假单胞菌Ⅰ类整合子基因盒的检测与耐药机制研究[J].现代预防医学,2014,41(14):2601-2603.
[6]杨明,钱扬会,赵强元,2013-2015年临床分离铜绿假单胞菌耐药性及Ⅰ类整合子变化分析[J].国际检验医学杂志,2017,38(7):886-889.
[7]中华人民共和国卫生部医政司.全国临床检验操作规程[M].南京:东南大学出版社,2006:770.
[8]向万忠,任碧琼.铜绿假单胞菌的耐药性变迁及耐药机制[J].国际检验医学杂志,2013,34(10):1323-1324.
[9] KIM H S, PARK B K, KIM S K, et al. Clinical characteristics and outcomes of Pseudomonas aeruginosa bactermia in febtile neutropenic children and adolescents with the impact of antibiotic resistance:a retrospective sdudy[J]. BMC Infections Diseases, 2017,17(1):500.
[10]辛力华,周昕,张爽,等.2008-2009年医院感染铜绿假单胞菌的耐药分析[J].中华医院感染学杂志,2012,7(22):1477-1479.
[11]吴晓勇,史俊敏,伍贤鼎.385株铜绿假单胞菌临床分布与耐药性分析[J].检验医学与临床.2013,10(1):126-127.
[12]张艳芳,冯广满.中山地区铜绿假单胞菌耐药性及亚胺培南耐药机制分析[J].南昌大学学报(医学版),2018,58(21):21-22.
[13]陈约慧,应芙蓉,詹玲玲,等.1543株铜绿假单胞菌感染的临床分布与耐药性分析[J].中国临床药理学杂志,2016,34(24):2814-2817.
[14]林丽容.铜绿假单胞菌分布及耐药情况分析[J].临床合理用药,2018,11(12):112-113.
[15]黄兴富,范华.铜绿假单胞菌的临床分布及对环丙沙星耐药机制的研究[J].中国实验诊断学,2014,18(3):437-440.
[16]方平安,熊域皎,鲍永强,等.836株铜绿假单胞菌的临床分布及耐药性分析[J].实用医院临床杂志,2018,15(5):201-204.
[17]张泳,林丽英.住院患者铜绿假单胞菌感染分布、耐药状况及预后影响因素[J].检验医学与临床,2018,15(24):3786-3787.
[18] STOVER C K, PHAM X Q, ERWIN A L, et al. Complete genome sequence of Pseudomonas aeruginosa PAO1, an opportunistic pathogen[J]. Nature, 2000,406(6799):959-964.
[19]郭良,肖秀飞,左娟,等.多重耐药铜绿假单胞菌院内感染的耐药性研究[J].中外医疗,2017,31:185-187.
[20]姜习新.多重耐药的铜绿假单胞菌Ⅰ类整合子与其多重耐药基因的相关性分析[J].检验医学与临床,2012,9(3):300-302.
[21] GAUR A, PRAKASH P, ANUPURBA S, et al. Possible role of integrase gene polymerase chain reaction as an epidemilolgical marker:study of multidrug-resistant acinetobacter baumannii isolated from nosocomial infections[J]. International Journal of Antimicrobial Agents, 2007,29(4):446-450.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |