铜绿假单胞菌医院感染耐药性和危险因素分析

Antibiotic resistance and risk factors of nosocomial infection caused by Pseudomonas aeruginosa

目的:分析医院铜绿假单胞菌(PAE)的分布和耐药性变化,为临床合理选用抗菌药物提供依据。方法:采用回顾性分析的方法对某院2004年1月-2008年12月所有送检的标本中,分离的769例铜绿假单胞菌的药敏实验结果进行统计学分析,并对相关危险因素进行分析。结果:①铜绿假单胞菌的分离率由2004年的23.2%到2009年的38.5%,痰占72.4%;②铜绿假单胞菌对亚胺培南西司他丁、头孢他啶、阿米卡星、头胞哌酮舒巴坦、头孢吡肟的敏感率约在70%;环丙沙星的敏感率在60%,但是敏感率有升高趋势;对头孢噻肟和复方磺胺的敏感率最低,约在10%;铜绿假单胞菌对常用的9种抗菌药物的耐药性呈上升趋势。③铜绿假单胞菌感染主要发生在重症监护病房(26.4%)和呼吸内科(17.9%);感染部位主要是下呼吸道(72.4%);老年患者最易感染(58.1%)。结论:危重的老年患者为铜绿假单胞菌的易感染人群,呼吸道为铜绿假单胞菌最常见的感染部位,铜绿假单胞菌临床耐药现象严重,做好耐药性检测,加强院内感染的控制和合理使用抗菌药物具有十分重要的意义。

OBJECTIVE To study the distribution, the drug sensitivity and drug resistance of Pseudomonas aeruginosa for advising physicians to administer drugs reasonably. METHODS To collect data of the 769 strains of bacteria separated from clinical specimen from Jan 2004 to Dec 2008 and make analysis on the drug sensitivity test. RESULTS （1）The detection rates？ of Pseudomonas aeruginosa increased year by year-in the past five years were 23. 2%,25. 4%, 29. 8%, 36. 4%,38. 6%. （2）The ratio of resistance for imipenem, ceftazidime, amikacin, cefoperazone/SBT and eefepime against PA was about 300,%. The sensitive rate of bactrim and cefotaxim were lower, only 10% or so. The resistant rate of nine antibiotics was in a rising tendency during the last five years. （3）The main departments with nosocomial infection caused by PA happened frequently were intensive care units （26. 4%） and respiration department （17. 9%）. The common sites were respiratory tract （72. 4%）,and the common population were old people （58. 1 %）. CONCLUSION The Pseudomonas aeruginosa is high resistance;it is important to adopt effective measures to control its spread and to adverse reasonable application of antimicrobial agents and drug sensitivity test to reduce the resistance of Pseudomonas aeruginosa.