铜绿假单胞菌与鲍曼不动杆菌的多重耐药性分析

Multidrug-resistant of pseudomonas aeruginosa and acinetobacter baumannii

目的分析多重耐药鲍曼不动杆菌与多重耐药铜绿假单胞菌的耐药性,为临床治疗提供依据。方法用VITEK-32微生物自动鉴定与药敏系统,对临床分离出的非重复铜绿假单胞菌56株、鲍曼不动杆菌72株进行鉴定、药敏试验,并对比分析两种菌的耐药性。结果鲍曼不动杆菌对阿米卡星、左氧氟沙星的耐药率最低,分别为2.8%和68.1%。铜绿假单胞菌对哌拉西林/他唑巴坦的耐药率最低,为19.6%,其次为阿米卡星与亚胺培南,均为37.5%。鲍曼不动杆菌对哌拉西林/他唑巴坦、庆大霉素、妥布霉素、氨曲南、环丙沙星、左氧氟沙星、头孢吡肟、头孢他啶和亚胺培南的耐药率明显高于铜绿假单胞菌,差异有统计学意义(P<0.01或P<0.05),只有对阿米卡星的耐药率低于铜绿假单胞菌(P<0.01)。71.7%的鲍曼不动杆菌只对阿米卡星敏感,鲍曼不动杆菌的多重耐药率(97.2%)显著高于铜绿假单胞菌(67.9%),P<0.01。结论铜绿假单胞菌、鲍曼不动杆菌的多重耐药现象严重,尤其是鲍曼不动杆菌,应加强耐药性监测。

Objective To analysis multidrug-resistant of Pseudomonas aeruginosa and Acinetobacter bau-mannii isolated from hospitalized patients and provide reliable reference for rational clinical use of antibiotics.Meth-ods The identification and antibiotics resistance test of 56 strains of Pseudomonas aeruginosa and 72 stranis of Acin-etobacter baumannii isolated from patients in emergency department from May 2009 to Oct 2011 were performed by VITEK-32 system.Results The resistance rate of Acinetobacter baumannii to Amikacin was the lowest (2.8%),fol-lowed by Levofloxacin(68.1%).The antibiotics resistance rate of Pseudomonas aeruginosa to Piperacillin/tazobactam was lowest(19.6%),followed by Amikacin and Imipenem(37.5%).The antibiotics resistance rate of Acinetobacter baumannii to Piperacillin/tazobactam,Gentamycin,Tobramycins,Aztreonam,Levofloxacin,Ciprofloxacin,Ceftazidime, Cefepime and Imipenem were significantly higher than that of Pseudomonas aeruginosa (P <0.01 or P <0.05),ex-cept for Amikacin,the resistance rate of Acinetobacter baumannii was lower than that of Pseudomonas aeruginosa (P<0.01).The multidrug-resistant rate of Acinetobacter baumannii (97.2%)was significantly higher than that of Pseudomonas aeruginosa(67.9%)(P <0.01),with 71.7% of Acinetobacter baumannii was only sensitive to Ami-kacin.Conclusion The multidrug-resistant rates of Pseudomonas aeruginosa and Acinetobacter baumannii are high,&nbsp;especialy for Acinetobacter baumannii.The antibiotics resistance monitoring and rational use should be paid more at-tention according to the results of drug susceptibility test.