耐亚胺培南铜绿假单胞菌的耐药现状研究

Investigation of drug resistance in imipenem-resistant Pseudomonas aeruginosa

目的探讨福建医科大学附属第一医院耐亚胺培南铜绿假单胞菌(IRPA)的感染现状,以指导临床有效使用抗生素。方法对2009年1月～2012年12月临床标本中分离的1721株铜绿假单胞菌的亚胺培南耐药性情况进行回顾性分析。结果 1721株铜绿假单胞菌中有736株为IRPA,2009、2010、2011、2012年IRPA分离率分别为29.42%、32.97%、45.67%、58.20%,呈逐年上升趋势。其中以2012年为例,ICU的分离率最高,为31.88%;标本中痰及咽拭子的分离率最高,为88.59%;除亚胺培南外,在其他常用的13种抗生素中,IRPA对替卡西林耐药率最高,为92.3%,对哌拉西林/他唑巴坦耐药率最低,为19.4%。结论 IRPA逐渐增多,且多种药物耐药现象严重,应加强对该菌的耐药性监测,合理使用抗菌药物,防止IRPA的蔓延。

Objective To explore the current status of infection of imipenem-resistant Pseudomonas aeruginosa (IRPA) in the First Affiliated Hospital of Fujian Medical University and to guide effective clinical use of antibiotics.Methods Imipenem resistantance of 1721 Pseudomonas aeruginosa isolated from clinical specimen from January 2009 to December 2012 were retrospectively analyzed.Results 736 strains in 1721 strains of Pseudomonas aeruginosa were IRPA.The sparation rate of IRPA from 2009 to 2012 was 29.42%,32.97%,45.67%,58.20% respectively,which showed an increasing trend.The data in 2012 was taken as example,in specimen source of different Department,the highest separative rate was 31.88% from ICU;in specimen type,the highest separative rate was 88.59% from phlegm and swallow swab.In addition to imipenem,in another 13 kinds of commonly used antibiotics,IRPA resistance to ticarcillin was the highest,92.3%,piperacillin/tazobactam was the lowest,19.4%.Conclusion It is gradually increased of IRPA,and the multi-drug resistance phenomena is serious.We should strengthen the monitoring of drug resistance of this bacteria and make rational use of antibiotics to prevent the spreading of IRPA.