全国医院感染监控网医院耐亚胺培南铜绿假单胞菌检出情况及药敏分析

Detection and antimicrobial susceptibility of imipenem-resistant Pseudomonas aeruginosa in hospitals in Chinese Nosocomial Infection Surveillance System

目的探讨耐亚胺培南铜绿假单胞菌（imipenem-resistant Pseudomonas aeruginosa，IRPA）在医院感染患者中检出情况及其对抗菌药物的敏感性。方法对1999年7月-2007年6月全国医院感染监控网医院（110所）医院感染患者资料中IRPA资料进行统计分析。结果检出的5490株铜绿假单胞菌中，进行亚胺培南药敏试验者3090株，其中检出IRPA940株（30．42％）。IRPA主要分布在医科大学（学院）附属医院及900张床位以上大型综合医院（847株，占90．11％）；按每2年一个时段，各时段相比，IRPA检出率显著升高（Χ^2=27．50，P=0．000）；IRPA主要来源于下呼吸道，占72．13％，其次为烧伤部位7．87％。IRPA对临床常用抗菌药物的耐药率均〉50％，对美罗培南的耐药率高达83．33％。结论IRPA检出率高，尤其是大型综合医院，呈现增长趋势与广泛耐药。

Objective To evaluate the detection and antimicrobial susceptibility of imipenem-resistant Pseudomonas aeruginosa （IRPA） isolated from patients with nosocomial infection. Methods Data about IRPA of patients in 1 10 hospitals in Chinese Nosocomial Infection Surveillance System （CNISS） between July, 1999 and June, 2007 were analysed. Results Among 5 490 strains of Pseudomonas aeruginosa, 3 090 strains were performed antimicro- bial susceptibility test of impenem, 940 strains （30. 42%） of which were IRPA. IRPA were mainly distributed in medical university （ college ）-affiliated hospitals and general hospitals with more than 900 beds （847 strains, 90. 11%）; 2 years were as a stage, the detection rate of IRAP increased significantly with every stage （Χ^2 = 27. 50, P= 0. 000）; IRAP were mainly from lower respiratory tract, which accounting for 72. 13%, the next were burn sites 7. 87%. Antimicrobial resistant rate of IRAP to commonly used antimicrobial agents in clinic were 〉50%, the resistant rate to meropenem was up to 83. 33%. Conclusion The detection of IRAP is high, especially in large general hospitals, there is a tendency of increase and broad drug-resistance