中文摘要：

目的：了解云南省三级医院2013-2015年血液标本中分离的铜绿假单胞菌的耐药状况，为临床治疗铜绿假单胞菌感染合理使用抗菌药提供依据。方法：选取云南省三级医院2013年1月-2015年12月各临床科室住院和门诊患者所送检的血液标本中分离的铜绿假单胞菌作为研究对象，采用 Whonet 5.6软件对所有血液标本中分离的铜绿假单胞菌进行抗菌药物耐药性统计分析，采用 SPSS 18.0统计学软件对血液标本来源和痰液标本来源的铜绿假单胞菌进行分析。结果：2013-2015年自血液标本中共分离出铜绿假单胞菌415株，铜绿假单胞菌的分离数量分别为115，143，157株。铜绿假单胞菌对氨曲南耐药率最高（31.4%），对阿米卡星的耐药率最低（15.2%），对一线抗假单胞菌的哌拉西林-他唑巴坦耐药率为22.7%。除美罗培南和妥布霉素外，对哌拉西林-他唑巴坦在内的其余抗菌药均呈上升趋势。血液标本来源的铜绿假单胞菌对哌拉西林、头孢吡肟、美罗培南、庆大霉素、阿米卡星的耐药率明显高于痰液标本的耐药率，差异有统计学意义（P＜0.05）。儿童患者来源的菌株对多数抗菌药的耐药率均低于成人患者和老年人患者来源的菌株。结论：2013-2015年云南省三级医院血液标本中铜绿假单胞菌的分离数量逐年增多，对包括一线抗菌药物哌拉西林-他唑巴坦在内的多数常用抗菌药物的耐药率逐年上升，对多种抗菌药物的耐药率较痰液标本来源的菌株高，应加强对血液标本中铜绿假单胞菌耐药率的连续监测以指导临床合理用药。

英文摘要：

Objective:To investigate the drug resistance of Pseudomonas aeruginosa isolated from the blood samples in tertiary hospitals in Yunnan province during 2013 - 2015 and provide a basis for the rational use of antibacterial drugs for clinical treatment of P. aeruginosa infection. Methods:The P. aeruginosa isolated from the blood samples in tertiary hosptials in Yunnan province from January 2013 to December 2015 were analyzed for resistance to antibacterial drugs by Whonet 5.6 software. The resistance rates of P. aeruginosa strains from blood and sputum samples were compared by SPSS 18.0 software. Results:A total of 415 P. aeruginosa strains were isolated from blood samples, including 115 in 2013, 143 in 2014 and 157 in 2015, which showed the highest resistance rate of 31.4% to aztreonam and the lowest resistance rate of 15.2% to amikacin. However, the resistance rate to piperacillin-tazobactam as a frist line antimicrobial agent was 22.7%. Apart from those to meropenem and tobramycin, the resistance rate of P. aeruginosa to other antimicrobial agents showed increasing tendencies. The resistance rates of P. aeruginosa strains from blood samples to piperacillin, cefepime, meropenem, gentamicin and amikacin were significantly higher than those from sputum samples (P < 0.05). The resistance rates of strains from children origin to most of antibacterial agents were lower than those from adult and the elderly orgins. Conclusion:The number of P. aeruginosa strains isolated from blood samples in tertiary hospitals of Yunnan province as well as the resistance rate to most routine antimicrobial agents including piperacillin-tazobactam increased year by year, while the resistance rate to several antibacterial agents were higher than those isolated from sputum samples. The monitoring on the drug-resistence of P. aeruginosa in blood samples should be strengthened so as to guide the rational drug use in clinic.