重症监护病房铜绿假单胞菌、鲍曼不动杆菌的耐药性研究

Study on the Antimicrobial Resistance of Pseudomonas aeruginosa and Acinetobacter baumanni Isolated From Patients in ICU

【目的】了解本院重症监护病房铜绿假单胞菌与鲍曼不动杆菌的分布及药敏结果 ,以指导临床抗生素的合理使用。【方法】从 2 0 0 0年起 ,每年采用E test法对连续 1个月收集的铜绿假单胞菌与鲍曼不动杆菌进行细菌药敏监测 ,同时使用WHONET 5 .1进行药敏结果的分析。【结果】84株铜绿假单胞菌对各类抗菌药物均有不同程度的耐药 ,其中对亚胺培南、头孢他定和头孢哌酮 /舒巴坦的敏感率分别为 83.3%、83.3%和82 .1% ,对头孢噻肟、头孢曲松的敏感率仅为 2 8.6 %和 4 0 .5 %。 75株鲍曼不动杆菌对亚胺培南的敏感率最高达 88% ,其余的都在 6 5 %及以下 ,头孢曲松、头孢噻肟的敏感率仅为 2 6 .7%、34.7%。【结论】重症监护病房的铜绿假单胞菌、鲍曼不动杆菌对抗菌药物的耐药性十分严重 ,必须加强抗菌药物在重症监护病房的耐药监测 ,根据药敏结果用药 ,以免造成严重的医院感染流行。

ObjectivesTo understand the distribution and results of drug sensitivity in Pseudomonas aeruginosa and Acinetobacter baumanni isolated from intensive care unit (ICU) patients and provide guidance for rational clinical application of antibiotics.Drug sensitivity monitoring towards Pseudomonas aeruginosa and Acinetobacter baumanni collected consecutively from patients in ICU for 1 month per year during 2000 to 2003 was performed by E-test methods. WHONET 5.1 was used simultaneously to analyze the results of drug sensitivity tests.Eighty-four strains of Pseudomonas aeruginosa isolated from clinical samples displayed different degree of drug resistance to various antibiotics, its rates of sensitivity towards imipenem,ceftazidime and cefoperazone/sulbactam were 83.3%、83.3% and 82.1%,respectively ; whereas those towards cefotaxime and ceftriaxone were only 28.6% and 40.5% ,respectively. Seventy-five strains of Acinetobacter baumanni isolated from clinical samples showed highest sensitivity rate to imipenem (88%), those towards other drugs were all about 65% or less ,their rates of sensitivity towards ceftriaxone and cefotaxime were only 26.7% and 34.7%, respectively.[Conclusions]Antibacterial drug resistance of Pseudomonas aeruginosa and Acinetobacter baumanni in ICU is still a serious clinical problem, surveillance of drug resistance in ICU should be strengthened. Administration of antibiotics must be based on results of drug sensitivity test to prevent the hospitals from severe prevalence of infection.