常用抗菌药物对101株铜绿假单胞菌的体外抗菌活性研究

A Study on in vitro activities of common antimicrobial agents against 101 strains of Pseudomonas aeruginosa

目的调查医院临床分离的铜绿假单胞菌对常用抗菌药物的体外抗菌活性,了解其耐药趋势,指导临床合理应用抗菌药物。方法收集2005—2006年临床分离的铜绿假单胞菌,药敏实验采用K-B纸片扩散法和琼脂平板稀释法,按NCCLS/CLSI规定的标准进行。结果铜绿假单胞菌在呼吸道的分离率为89.11%,头孢吡肟、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的最低抑菌浓度(MIC)90已达到256μg/ml,头孢他啶为128μg/ml,亚胺培南为64μg/ml,美罗培南和帕珠沙星为32μg/ml。除美罗培南和哌拉西林/他唑巴坦的抑菌率分别为70.30%和68.31%,其余均在50%以下,其中头孢哌酮/舒巴坦的抑菌率仅为19.80%。结论铜绿假单胞菌的感染主要为呼吸道标本,临床应加强对呼吸系统感染的护理和监控,铜绿假单胞菌的多重耐药现象越来越高,临床治疗其感染应根据药敏实验和患者的个体情况合理联合应用抗菌药物。

Objective To investigate the in vitro activities of common antimicrobial agents against 101 strains of Pseudomonas aeruginosa, understand the trend and mechanism of drug resistance and provide guidance for proper use of antimicrobial agents in clinical practices. Methods From 2005 to 2006, 101 strains of Pseudomonas aeruginosa isolated in our hospital were evaluated with drug sensitivity test using Kirby-Bauer disk diffusion and agar plate dilution method according to NCCLS recommendations. Data on MIC50 and MIC90 were analyzed. Results About 89% of the P. aeruginosa strains were isolated from respiratory tracts. Of all strains tested, the MIC90 was as high as 256μg/ml for Cefepime, Piperacillin/Tazobactam and Cefoperazone/Sulbactam, 128μg/ml for Ceftazidime , 64g/ml for Imipenem and 32μg/ml for Meropenem and Pazufloxacin. Except for Meropenem （70.30%） and Piperacillin/Tazobactam （68.31%）, less than 50% of the strains were inhibited by the antimicrobial agents test, Cefoperazone/Sulbactam （19.80%） in particular. Conclusion Pseudomonas aeruginosa appears predominant in samples from respiratory tracts. Therefore, respiratory infections should attract closer care and monitoring in clinical practices. In view of the increasing muhidrug resistance, treatment of infection with P. aeruginosa should be rational use of combined antimicrobials based on susceptibility test and individual condition of patients.