铜绿假单胞菌的临床分布和耐药性变迁

Clinical distribution and drug resistance study of Pseudomonas aeruginosa

目的调查温州医学院附属第一医院铜绿假单胞菌的临床分布和耐药性及其变迁情况,指导临床合理用药和控制耐药菌的产生。方法对该院2003年至2005年437株铜绿假单胞菌进行回顾性分析,用17种抗菌药物进行体外药敏试验。结果铜绿假单胞菌分布以呼吸道感染和创口分泌物感染为主。细菌对第3代头孢菌素耐药率高,对头孢他啶、亚胺培南、头孢哌酮/舒巴坦和氟喹诺酮类药物的耐药率均有逐年增加的趋势。耐药率增加与临床广谱抗菌药物用药量增加有关。结论铜绿假单胞菌的耐药性十分突出,应在药敏指导下合理选用抗菌药物,应该适当控制碳青霉烯类和第3代头孢菌素的使用,减缓耐药菌株的产生。

Objectives To investigate the clinical distribution and the change of antibiotic resistance of Pseudornonas aeruginosa（Pa） in hospital ,providing a referenee for elinieal applieation of antimierobial and drug resistanee control strategies. Methods 437 patients infected with Pa in our hospital from Jan. 2003 to Dee. 2005 have been analyzed. Drug sensitivity tests were made for 17 antimierobial agents. Results The most Pa was eultured from the infeetion of breathway and wounds in our hospital. The drug-resistanee rate of Pa to the third generation eephalosporins was high. Drug-resistance rate of eeftazidime, imipenem, eefoperazone-sulbaetam and fluorquinolones had the trend to gradually beeome more and more serious with the year inereased. The increased drug-resistenaee was related to the inereased usage of broad-speetrum antibioties. Conclusions The drug resistanee of Pa is highly prominent. Antimierobial treatment for Pa infeetion should be guided by drug-sensitivity test. The usage of the earbapenems and the third generation eephalosporins needs to be strategieally controlled to delay the drug-resistanee strains spread.