铜绿假单孢菌耐药性分析及防治策略

Strategies to Control the Resistance Pseudomonas Aeruginosa

目的了解我院2008年7月-9月临床分离的铜绿假单胞菌株分布特征及耐药情况,为临床治疗用药提供参考。方法将我院患者送检标本进行分离、培养,采用细菌生化常规法进行菌株鉴定,采用仪器法进行药敏试验。结果252株铜绿假单胞菌(PA)中有231株来自痰液及咽拭子(91.67%),分离出PA的科室分别为重症监护病房(ICU)占51.19%,非ICU占48.81%;药敏结果显示,PA对β-内酰胺类、氨基糖苷类、喹诺酮类、磺胺类抗菌药物有很高的耐药性,耐药率均大于70.00%,而对碳青酶烯类药物亚胺培南、部分β-内酰胺类含酶抑制剂复合药有较低的耐药率,最低者是头孢哌酮/舒巴坦31.25%,其次是亚胺培南52.38%,以及哌拉西林/他唑巴坦66.67%。结论铜绿假单胞菌临床分离菌株多来自于痰及咽拭子标本和ICU病房,并对多种抗菌药物的耐药率较高,多重耐药性明显,临床应加强对PA耐药性的监控,并防止耐药菌株的传播流行。

Objective To provide information for clinical medication through comprehending the distribution characters and resistance status of Pseudomonas aeruginosa in clinic from 2008.7-2008. 9 in our hospital. Methods The samples from patients were separated, cultivated and then evaluated in bacteria biochemistry common practice. Susceptibility test was carried out with instrumental method. Results There were 231（91.67%）strains from sputum and throat swab in the total 252 PA. The separated PA came from ICU（51.19%） and non-ICU（48.81%）. It was demonstrated by the susceptibility test that PA was highly tolerant to β-lactam, aminoglycosides, quinolones and sulfanilamide group. The resistant rate was more than 70%, whereas the resistance rate to imipenem and some of the β-lactam enzyme inhibitor compound medicine was relatively lower. Cefoperazone/subactam＇s resistant rate（31.25%）was the lowest. The second lowest was imipenem （52. 38%）and the next was piperacillin/tazobactam （66.67%）. Conclusion Pseudomonas aeruginosa clinical separation strains comes from sputum, throat swab and ICU. It is highly resistant to many antibacterials and the multidrug resistance is obvious. It is necessary to monitor the resistance of PA and prevent the spread of the resistant strains.