2003-2009年我院铜绿假单胞菌耐药性监测分析

Monitoring and Ananlysis of Antibiotic Resistance in Clinical Islolated Pseudomonas Aeruginosa From 2003 to 2007

目的:分析2003-2009年临床分离的1 040株铜绿假单胞菌的耐药变化趋势和分布情况,为临床合理选用抗菌药物和控制院内感染提供依据。方法:采用全自动微生物分析仪VITEK32进行细菌鉴定,K-B纸片扩散法进行药敏试验。运用WHONTE 5.4软件分析铜绿假单胞菌的分布、分离率及药敏结果。结果:铜绿假单胞菌在痰标本中分离最多(78.8%),并且其耐药性明显高于分离于其他标本中的菌株。近7年中临床分离的铜绿假单胞菌对各种抗生素的耐药率基本呈逐年上升趋势,尤其对CIP、AN、CAZ、PIP的耐药率上升趋势最为明显。在常用的抗生素中,仅有IPM和CSL保持相对较高的敏感性(耐药率<30%)。结论:铜绿假单胞菌对各种抗生素的耐药性呈逐年上升的趋势,临床应选择敏感性较高的碳青霉烯类和β内酰胺酶抑制剂类药物作为经验用药,以控制耐药菌株的产生和流行。

Objective To analyze the changes of drug resistance and distribution in 1 040 clinical isolated pseudomonas aeruginaosa from 2003 to 2007,in order to provide the basis for rational administration and infection control.Methods The identification of bacteria were performed by automated microbe annlyzer(VITEK32) and antibiotic sensitivity test were adopted kirby-bauer method.The data of sample distribution,isolated rate and drug resistant of Pseudomonas aeruginaosa were analyzed by WHONET 5.4 software.Results Most of Pseudomonas aeruginaosa were isolated from respiratory specimens,and the drug resistant rate was significantly higher than those isolated from other specimens.In recent seven years,the isolation and drug resistance ratio of Pseudomonas aeruginaosa to all kinds of antibiotics were increasing year by year.The drug resistance of Pseudomonas aeruginaosa to ciprofloxacin,amikacin,ceftazidime and piperacillin were increased obviously.In routine antibiotics,only the drug resiatance of Pseudomonas aeruginaosa to imipenem and cefoperazone-sulbactam were lower than 30%,the drug resistance of other antibiotics were over 40%.Conclusion The drug resistance ratio of Pseudomonas aeruginaosa to all kinds of antibiotics were increased year by year,the relative sensitive antibiotics,such as carbepem or β-lactams enzyme deressor/β-lactams antibiotic should be used as routine empirical therapy so as to reduce the occurrence and spread of antibiotic resistant bacteria.