湖北地区2000～2007年铜绿假单胞菌临床分离株的耐药性分析

Analysis of drug resistance on clinical Isolates of pseudomonas aeruginosa from year 2000 to 2007 of Hubei province

目的了解湖北地区临床分离的铜绿假单胞菌的耐药变迁，为临床合理使用抗生素提供依据。方法综合分析湖北地区17家医院2000～2007年的铜绿假单胞菌分离情况及其对各种抗生素的耐药率。结果湖北地区铜绿假单胞菌的年分离量和对各抗生素的耐药率基本呈逐年上升的趋势，对头孢唑啉、头孢呋辛的耐药率几乎达100％，对头孢曲松、头孢噻肟的耐药率〉50％，对庆大霉素、加替沙星的耐药性大大增加（耐药率在40％～50％之间），对环丙沙星、左氧氟沙星、氨曲南、哌拉西林、他唑巴坦保持中度敏感性（耐药率在30％--40％之间），对阿米卡星、头孢哌酮／舒巴坦、头孢他啶、头孢吡肟、亚氨培南、美洛培南保持相对较好的敏感性（耐药率〈30％）。结论铜绿假单胞菌对各种抗生素的耐药性逐年增加，临床上应选择敏感性相对较好的药物作为铜绿假单胞菌的经验用药，以避免医疗成本的浪费及耐药性加剧。

Objective To investigate changes of the drug resistance on clinical P. aeruginosa isolates of Hubei province, and offer reasonable experimental data for clinical therapy. Methods Profile of clinical isolates and drug resistance of P. aeruginosa isolated from seventeen hospitals in Hubei province from year 2000-2007 were analyzed synthetically. Results The isolations and the ratio of drug resistance of P. aeruginosa to all kind of antibiotics were increasing year by year. The ratio of drug resistance to Cephazolin and Cefuroxime almost reached 100% ;h is highly resistant to Ceftriaxone and Cefotaxime （ 〉 80% ） ;The drug resistance to Gentamicin and Gatifloxacin were largely raising （40%-50% ） ;It is moderate resistant to Ciprofloxacin, Levofloxacin, Aztreonam, and Piperacillin and Tazobactam（ 30% -40% ） ; It is relative sensitive to Amikacin, Cefoperazone and Sulbactam, Ceftazidime, Cefepime, Imipenem, and Meropenem （ 〈 30% ）. Conclusion The ratio of drug resistance of P. aeruginosa to all kind of antibiotics were increasing year by year, the relative sensitive antibiotics should be choosed as clinic empirical therapy, to avoid waste of medicine resources and deterioration of drug resistance.