ICU与非ICU铜绿假单胞菌感染的耐药性对比研究

Drug Resistance of Pseudomonas aeruginosa in Intensive Care Unit and Non-intensive Care Unit:A Comparative Study

目的 对比重症监护病房（ICU）与非ICU铜绿假单胞菌的细菌耐药性,为临床合理用药提供依据。方法 采用ATB细菌鉴定仪,对铜绿假单胞菌进行检测,药敏试验用K-B纸片法,根据2005年美国临床实验室标准化委员会（NCCLS）标准判断结果,应用WHONET5软件对临床分离细菌的药敏结果进行数据统计分析。结果 ICU分离菌对亚胺培南和美罗培南耐药率为41.4%和43.0%,分别高于非ICU 33.3%和33.6%（P〈0.05）,对左氧氟沙星、哌拉西林、哌拉西林/他唑巴坦、环丙沙星、氨曲南、阿米卡星的耐药率高于非ICU 8.6%-32.2%（P〈0.05）,ICU与非ICU对抗菌药物耐药率差异有统计学意义（P〈0.05）。结论 ICU铜绿假单胞菌耐药性显著高于非ICU,尤其是碳青酶烯类抗菌药物,应引起临床医师的高度重视。

OBJECTIVE To compare the drug resistance of Pseudomonas aeruginosa in intensive care units（ICU）and non-ICU for the guidance of clinical rational use of antimicrobial drugs. METHODS The P. aeruginosa isolates were detected by ATB microbiological system, and the antibiotics susceptivity by Kirby-Bauer（K-B）test. The results were evaluated based on National Committee for Clinical Laboratory Standards（NCCLS） in 2005. The data were analyzed by using WHONET-5 software. RESULTS The resistant rate of P. aeruginosa isolates from ICU to imipenem and meropenem was 41.2% and 43.0%, respectively, higher than from non-ICU （33.0% and 33.6%） （P〈0. 005）. The resistant rate of P. aeruginosa isolates from ICU to levofloxacin, piperacillin/tazobactam, piperacillin, ciprofloxacin, aztreonam, and amikacin （8. 6-32.2%） were higher than from non-ICU （P〈0. 005）. There was significant difference between the resistant rate of ICU and non-ICU to antimicrobial drugs （P（0.005）. CONCLUSIONS The drug resistance of P. aeruginosa isolated from ICU patients to many antimicrobial drugs was higher than from non-ICU patients, especially to carbapenems. Close attention should be taken by the clinical doctors.