铜绿假单胞菌临床分离株的耐药性分析

Drug-resistance of Pseudomonas aeruginosa Isolated from Patients in Hospital

目的分析2006年1月-2008年12月医院痰液中分离的铜绿假单胞菌耐药性与耐药趋势,为临床预防感染以及合理用药提供依据。方法采集来自各临床科室送检的痰标本,采用美国VITEK-32自动微生物分析仪进行细菌学培养鉴定及药敏试验。结果196株铜绿假单胞菌对16种抗菌药物中对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、奈替米星的耐药率为18.37%、16.84%、18.88%、17.35%,而耐药率最高的是复方新诺明(100.00%)、氨苄西林(99.49%)、头孢唑林(99.49%)、头孢替坦(88.78%)、头孢曲松(79.08%);头孢类抗菌药物耐药率有上升趋势,哌拉西林/他唑巴坦和替卡西林/克拉维酸耐药率有下降趋势。结论铜绿假单胞菌单一及多药耐药情况均较严重,对β-内酰胺酶抑制剂复合药物、氨基糖苷类保持较好的敏感性,根据药敏结果合理使用抗菌药物是延缓其耐药株快速升高的最好办法。

OBJECTIVE To investigate the change of antibiotics resistance of the Pseudomonas aeruginosa isolated from patients′s sputum in our hospital from Jan 2006 to Dec 2008,and offer basis for prevention of clinical infection and the reasonable use of drugs.METHODS The culture,identification and sensitivity to antibiotics of P.aeruginosa from the clinical sputum specimens were analyzed using USA VITEK-32 system.RESULTS Totally 196 strains of P.aeruginosa were isolated and characterized during the three years.The rates of resistance to cefoperazone/sulbactam were 18.37%,piperacillin/tazobactam 16.84%,netilmicin 17.35%,trimethoprim/sulfamesoxazole 100.00%,ampicillin 99.49%,cefazolin 99.49%,cefotetan 88.78%,and to ceftriaxone were 79.08%.The resistance rate to cephalosporins showed rising tendency.But the resistance rate to β-lactam antibiotics showed deereasing tendency.CONCLUSIONS P.aeruginosa has single and multi-resistance to antibiotics seriously,but sensitive to β-lactam antibiotics and aminoglycosides.Using antibiotics reasonably based on bacteria identification and sensitivity test is the best way to reduce the resistance of the pathogens.