烧伤病区铜绿假单胞菌对亚胺培南的耐药水平调查及药敏分析

Surveillance of resistant level of Pseudomonas aeruginosa to imipenem in burn wards and the analysis of their antimicrobial susceptibility

目的 调查某烧伤中心住院患者烧伤创面分泌物、工作人员手、病区环境中分离的铜绿假单胞菌对亚胺培南的耐药水平 ,并比较亚胺培南敏感株和耐药株对常用抗菌药物的耐药性。方法 用E test试条法检测铜绿假单胞菌对亚胺培南的MIC值 ,用K B纸片法测定对其他 11种抗菌药物的敏感性。结果 132株铜绿假单胞菌对亚胺培南的MIC50 ,MIC90 ,MICgm(MIC几何均数 )分别为 1.5 ,32 ,1.94 μg/mL。对亚胺培南的耐药率为13.6 4 %。亚胺培南敏感组和耐药组比较 ,耐药株对 11种抗菌药物的耐药率普遍较敏感株高 ,一般相差 2倍以上。有 8株菌 (全部来源于严重烧伤患者 )对受试的 12种抗菌药物全部耐药。结论 临床细菌耐药性日益严重 ,应密切关注本地区甚至本病区细菌耐药性的变迁 ,适时调整治疗方案 ,合理应用抗菌药物。

Objective To survey the imipenem (IMP) resistance of Pseudomonas aeruginosa isolated from the in-patients, health care workers' hands and the environment of a burn center, and to compare the resistance of IMP susceptible isolates to commonly used antimicrobial agents with those of IMP resistant isolates. Methods The MIC values of Pseudomonas aeruginosa to IMP were determined by E-test strips and their susceptibility to other 11 antimicrobial agents were tested by the Kirby-Bauer method. Results The MIC 50 , MIC 90 and MIC gm of 132 isolates to IMP was 1.5 , 32 and 1.94 μg/mL , respectively. The total resistant rate to IMP was 13.64% . The resistant rates of IMP susceptible isolates to 11 antimicrobial agents were much higher than those of susceptible isolates. 8 strains isolated from serious burn patients were resistant to the total 12 antimicrobial agents. Conclusion The resistance of clinical bacteria was more serious than before. It is necessary to pay close attention to the bacteria resistant changes and to adjust the treatment plans at the right moment in order to use antimicrobial agents rationally.