铜绿假单胞菌的临床分离及耐药性分析

Drug Resistance Analysis and Clinical Separation of Pseudomonas aeruginosa

目的探讨铜绿假单胞菌在不同临床科室的分布,以及各种送检标本中铜绿假单胞菌的构成比和对抗菌药耐药情况,为临床合理用药提供参考。方法铜绿假单胞菌培养与鉴定按照《全国临床检验操作规程》进行,药敏试验采用纸片扩散法。结果 572株铜绿假单胞菌主要分布在NICU神经外科(一)、重症医学科和呼吸内科,在各种样本中,痰中检出铜绿假单胞菌最多,为434株,占总数的75.9%,其次为尿液,为30株,占5.2%;铜绿假单胞菌对磺胺甲恶唑/甲氧苄啶、四环素、米诺环素、头孢噻肟、替卡西林/克拉维酸、头孢哌酮、氨曲南、哌拉西林、左氧氟沙星的耐药率分别为98.6%、94.93%、93.53%、71.15%、57.17%、44.93%、43.88%、40.38%、40.38%,对多黏菌素B、阿米卡星、妥布霉素保持较好的敏感性。结论铜绿假单胞菌耐药性比较严重,医院应加强预防与控制,以期延缓细菌耐药性。

OBJECTIVE To explore the distribution of PAE in different clinical sections, the constituent ratio of PAE in all kinds of specimens sent to detect, and the drug resistance of PAE, to provide the reference for rational drug application in clinics. METHODS Cultivation and identification of PAE were performed according to OPERATION PROCEDURES OF NATIONAL CLINICAL LABORATORY, and Kirby-Bauer （K-B） was used for drug sensitivity test. RESULTS 572 strains PAE were mainly distributed in NICU Intensive Care Unit（ICU） and Respiratory Medicine. In various specimens, 434 strains PAE were detectedout in sputum, accounting for 75.9%, secondly, 30 strains PAE were detected in urine specimens, accounting for 5.2%. The rates of drug resistance of PAE to the 20 kinds of antibacterial drugs were respectively as follows： to SMZ was 98. 6%, to Tetracycline was 94.93%, to Minocycline was 93.53%, to Cefotaxime was 71.15 %, to Ticareillin/clavulanic acid was 87. 17%, to Cefoperazone was 44. 98%, to Aztreonam was 43. 88%, to Piperacillin was 40. 38%, to Levofloxacin was 40. 38%, and it remained preferably sensitive to Polymyxin B, Amikacin and Tobramycin. CONCLUSIONS Since PAE has severe drug resistance, the prevention and control should be strengthened in hospital to suspend its drug resistance.