老年病房分离铜绿假单胞菌的耐药性分析

Analysis of antibiotic resistance of Pseudomonas aeruginosa isolated from patients in Department of Geriatrics

目的分析老年病房分离铜绿假单胞菌对临床常用抗菌药的耐药特征,为临床用药提供参考。方法收集我院老年病房2004年1月至2005年12月的住院患者分离菌株,药敏试验采用K-β扩散法。结果共分离出230株铜绿假单胞菌,其中224株来自痰标本。哌拉西林/他唑巴坦的敏感率最高,为64.8%,其他依次为阿米卡星、环丙沙星、头孢哌酮-舒巴坦;头孢他啶的耐药率最高,为50.9%,其他依次为哌拉西林、头孢吡肟、亚胺培南等。其对头孢他啶、头孢吡肟、亚胺培南的耐药率皆显著高于同期非老年病房分离株(P<0.01);多重耐药铜绿假单胞菌(MDRP)105株,占分离菌株的45.6%;71.5%的患者在标本分离的前2月里,接受过多种抗菌药物治疗。结论密切结合药敏试验,合理有序的应用抗生素、减轻抗生素的选择性压力,对于防治铜绿假单胞菌的耐药及传播,控制老年病房的院内感染具有重要意义。

Objective To analyze the resistance characteristics of Pseudomonas aeruginosa isolated from patients in Department of Geriatrics for the purpose of guiding therapy. Methods Bacterial strains were collected from January 2004 to December 2005 from Department of Geriatrics. K-β disk diffuse method was used in susceptibility testing. Results A total of 230 strains of Pseudomonas aeruginosa were isolated. Among them, 224 strains were from sputum. In all antimicrobial agents studied, the most sensitive one was azobactam（64. 8% ）, followed by mikaicin （55.7%）, and cefoperacillin-sulbactam （53.7%）. Pseudomonas aeruginosa exhibited high resistance to eftazidime（ 50. 9% ）, followed by Piperacillin （49. 1% ）, Cefepime （44. 1% ） and Imipenem （43.5%）. The resistance of Pseudomonas aeruginosa isolated from patients presenting to Department of Geriatrics to Ceftazidime, Cefepime and Imipenem was more serious than those from patients presenting to non-geriatrics departments （P 〈 0. 01 ） ;A total of 105 multi-drug resistant Pseudomonas aeruginosa （MDRP） （45.6%） were isolated. 71.5% patients accepted 2 or more kinds of treatment of antimicrobial agent in two months before isolatiaon of samples. Conclusions Rational and orderly administration of antibiotic based on drug susceptibility is critical to prevent and reduce the resistance and transimisson of Pseudomonas aeruginosa.