铜绿假单胞菌医院感染与耐药性分析

Nosocomial Infection with Pseudomonas aeruginosa and Approach of Drug-resistance:A Clinical Overview

目的探讨铜绿假单胞菌(PAE)医院感染的耐药性,为医院感染的监测与控制提供依据。方法采用美国MicroScan WalkAway-40细菌鉴定仪将PAE进行鉴定,并采用K-B纸片扩散法进行体外耐药监测及统计耐药率。结果2年中检出325株PAE,其中对耐亚胺培南铜绿假单胞菌(IRPA)占总株数的14.8%;PAE分离率最高的病区为重症监护病房(ICU),占20.9%;其次为老年病科,占19.4%;第3为呼吸内科,占16.9%;IRPA对11种常用抗菌药物的耐药率明显高于非耐药株,IRPA除对头孢他啶、头孢吡肟、氨曲南等3种抗菌药物耐药率均<50.0%外,对其余8种抗菌药物耐药率均>50.0%。结论PAE的耐药性已十分严重,必须进行严密的监控,预防PAE导致的医院感染暴发流行。

OBJECTIVE To investigate nosocomial infection and drug-resistance of Pseudomonasaeruginosa （PAE） in our hospital to provide the evidence for clinical monitoring and control of nosocomial infection. METHODS The microbiological system MicroScan WalkAway-40 was used to identify PAE and the drug-resistance in vitro was determined by K-B methods. RESULTS Among 325 strains of PAE in two years, imipenem-resistant P. aeruginosa （IRPA） accounted for 14.8%. The highest isolating rates occurred in the intensive care unit （ICU）, accounted for 20.9%. The following was senile disease department, accounted for 19.4%. The respiratory department rated the third, accounted for 16. 9%. The resistance of IRPA to 11 kinds of common antibiotics was significantly higher than imipenem-sensitive P. aeruginosa （ISPA）. Except the drug-resistance of IRPA to ceftazidime, cefepime and aztreonam was below 50.0%, that to the other eight antibiotics was all over 50.0%. CONCLUSIONS The drug-resistance of PAE is very serious in our hosptial. We should perform rigorous monitoring and prevent the outbreak of nosocomial infection with PAE.