铜绿假单胞菌耐药性分析

Resistance Analysis of Pseudomonas aeruginosa

目的了解医院铜绿假单胞菌的分布及耐药状况。方法标本经分离培养,采用美国德灵公司Walk-Away-40全自动细菌鉴定系统及配套的NC21鉴定板,对菌株进行鉴定和药敏实验。结果62株铜绿假单胞菌中36株来源于痰对头孢噻肟、头孢曲松耐药率分别55.6%、47.5%,其他β-内酰胺类抗菌药物的头孢他啶、哌拉西林/他巴唑坦、哌拉西林耐药率分别为7.5%、11.0%、30.0%,亚胺培南的耐药率达20.0%,阿米卡星的耐药率最低4.6%。结论铜绿假单胞菌是下呼吸道感染的主要致病菌之一,其耐药机制复杂,有多重耐药的特性,能天然抵抗多种抗菌药物;希望临床医生在治疗铜绿假单胞菌的感染过程中,充分考虑其耐药机制,选用耐药率低的药物,避免诱导铜绿假单胞菌产生β-内酰胺酶而对抗菌药物广泛耐药。

OBJECTIVE To investigate the distribution and drug resistance of Pseudomonas aeruginosa. METHODS All specimens isolated and cultured from patients in our hospital were identified by using the automatic microorganism analyzer WalkAway-40, Dade Behring made in America,and bacteria＇s drug susceptibility test and identifications were performed on strains using NC21 Microscan Panel. RESULTS From sixty-two strains of P. aeruginosa 36 strains were isolated of sputum. The resistance rate to the third generation of cephalosporins cefotaxime and ceftriaxone was 55.6% and 47. 5%, respectively. The resistance rate to the other β-lactamases antibiotics such as ceftazidime was 7.5%, piperacillin/tazobactam 11.0%, cefepime 14. 8% and penicillin was 30.0%, the ratio of resistance for imipenem was 20.0%, the lowest one was amikacin（4.6%）. CONCLUSIONS P. aeruginosa is one of the main bacteria in the lower respiratory tract infection. The drug-resistant mechanism of P. aeruginosa is very complex, including multidrug resistance characteristics, and it is originally resistant to several antibiotics. To avoid being produced β-lactamases and result in resisting drug widely, the antibiotics should be selected according to low drug-resistant rate and taking into account sufficiently its drug resistance mechanism in the treatment of P. aeruginosa infection.