新生儿铜绿假单胞菌感染及耐药性监测

Nosocomial Infection and Antimicrobial Resistance of Pseudomonas aeruginosa among Neonates

目的分析铜绿假单胞菌引起新生儿感染的特点及对常用抗菌药物的耐药谱,为临床治疗用药提供合理方案。方法采用API细菌鉴定分析系统,对住院新生儿临床分离细菌进行鉴定,并采用K-B法选用17种常用抗菌药物进行体外药物敏感试验。结果131株铜绿假单胞菌主要来源于痰和胃液标本,共占74.8%;其在临床病区分布以新生儿重症监护病房(NICU)为主,占82.4%;131株铜绿假单胞菌对阿米卡星、左氧氟沙星、环丙沙星、氧氟沙星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南的敏感率较高,均>70.0%;而对哌拉西林、美洛西林、头孢哌酮、头孢曲松、头孢他啶、头孢吡肟、氨曲南的敏感率则次之。结论铜绿假单胞菌是引起新生儿医院感染的最常见病原菌之一,对抗菌药物呈多重耐药,临床治疗应结合新生儿的特点合理选用抗菌药物,以减少耐药株的出现与扩散。

OBJECTIVE To investigate the distribution of drug resistance of Pseudomonas aeruginosa （PAE） among neonates and analyze the characteristic of the PAE infection. METHODS API system was used for the identification of 131 PAE clinical isolates and the resistance to 17 kinds antibiotics was determined by K-B method. RESULTS Most of 131 strains were isolated from sputum （42. 0%） and gastric juice （32. 8%）. All strains were mainly isolated from neonate intensive care unit （NICU）. The sensitivity to amikacin, levofloxacin, ofloxacin, ciprofloxacin, piperacillin/tazobactam, cefoperazone/sulbactam, imipenem and meropenem was respectively over 70.0%. P.AE was inferior sensitivity to piperacillin, mezlocillin, cefoperazone, ceftriaxone, ceftazidime and aztreonam. CONCLUSIONS PAE is one of the most common pathogens causing nosocomial infection especially for neonates. Its susceptibility to antibiotics showed multidrug resistance. In order to reduce or prevent the occurrence of resistant isolate,we should rationally choose and use antibiotics combining with trait of neonate.