摘 要 目的 了解某三级医院耐碳青霉烯铜绿假单胞菌的临床分布情况，及其检出率与碳青霉烯类抗菌药物DDDS相关性，为临床治疗、院感防控及合理用药提供参考依据。方法: 梳理2017-2021年本院分离的临床菌株，采用WHONET 5.6及SPSS 23.0 软件对数据进行分析。 结果 本院2017年至2021年间分离铜绿假单胞菌（PA）622株，其中CRPA 91株，检出率为14.63％。CRPA科室分布以呼吸与危重症医学科（31.87%）、重症医学科（23.08%）、神经外科（18.68%）为主。标本类型中，以痰和肺泡灌洗液为主，占81.32%，其次为伤口分泌物和尿液，分别占6.59%和5.49%。年龄分布以>80岁（25.27%）和60～80岁（29.67%）人群最多见。碳青霉烯类抗菌药物DDDS分析结果显示，2017年至2021年CRPA检出率与碳青霉烯类抗菌药物DDDs呈高度正相关（r=0.82 P=0.086）。临床科室中，神经外科CRPA检出率与碳青霉烯类抗菌药物DDDS呈正相关（r=0.78 P=0.122）。结论 本院所分离CRPA检出率与碳青霉烯类抗菌药物DDDS呈正相关，为避免常见感染菌和定植菌耐药的发生，应进一步加强抗菌药物管理，促进临床合理用药。
Abstract
Abstract：Objective To investigate the clinical distribution of carbapenem-resistant pseudomonas aeruginosa（CRPA）in a tertiary hospital, and the correlation ship between the CRPA detection rate and DDDS of carbapenem antibiotics, so as to provide basis for clinical treatment, prevention and control of hospital infection and rational use of antibacterial drugs. Methods Clinical strains isolated from our hospital from 2017 to 2021 were analyzed by WHONET 5.6 and SPSS 23.0 software. Results 622 pseudomonas aeruginosa (PA) were isolated from our hospital from 2017 to 2021, including 91 CRPA , with a detection rate of 14.63%. CRPA departments were mainly distributed in respiratory and critical care medicine (31.87%), Intensive Care Unit (23.08%) and neurosurgery (18.68%). Among the main specimen types, sputum and alveolar lavage fluid accounted for 81.32%, followed by wound secretion and urine, accounting for 6.59% and 5.49%, respectively. The age distribution of >80 years old (25.27%) and>60-80 years old (29.67%) was the most common. According to DDDS analysis results, the detection rate of CRPA from 2017 to 2021 was positively correlated with DDDS (R=0.82 P=0.086). In clinical departments, The detection rate of CRPA in neurosurgery was positively correlated with DDDS (R=0.78 P=0.122). Conclusion There is a positive correlation ship between CRPA isolated in our hospital and DDDS of carbapenem antibiotics. In order to avoid the occurrence of common infection and resistance of colonized bacteria, antimicrobial management should be further strengthened to promote rational clinical drug use.
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