新生儿铜绿假单胞菌耐药性分析

Study in antimicrobial resistance of Pseudomonas aeruginosa among neonates

目的:了解新生儿患者临床分离的铜绿假单胞菌耐药情况。方法:采用API细菌鉴定分析系统对2004—2008年湖北省妇幼保健院新生儿住院患者临床分离细菌进行鉴定,并采用Kirby-Bauer法选用13种常用抗菌药物进行体外药物敏感试验。结果:354株铜绿假单胞菌主要来源于痰和胃液标本,共占74.6%;其在临床病区分布中以重症监护病房为主,占81.9%。354株铜绿假单胞菌对环丙沙星、阿米卡星、头孢他啶、头孢吡肟、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南和美罗培南的敏感率较高,均>80%;而对哌拉西林、美洛西林、头孢噻肟、头孢哌酮、氨曲南的敏感率则次之。354株铜绿假单胞菌中多重耐药菌占25.7%,且有逐年增多的趋势。结论:铜绿假单胞菌是引起新生儿医院感染的最常见病原菌之一,对抗菌药物呈多重耐药,临床治疗应结合新生儿患者的特点合理选用抗菌药物,以减少耐药株的出现与扩散。

Objective：To investigate the distribution of drug resistance of Pseudomonas aeruginosa（PA） among neonates.Method：354 PA clinical isolates were identified with API system and the resistance of 13 kinds antibiotics was determined by Kirby-Bauer method.Result：Most of 354 strains were isolated from sputum（41.8%） and gastric juice（31.8%）.354 strains were mainly isolated from neonate intensive care unit（NICU）.The sensitivities of ciprofloxacin,amikacin,ceftazidime,cefepime,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem were all over 80 %.PA was inferior sensitive to piperacillin,mezlocillin,cefotaxime,cefoperazone and aztreonam.The prevalence of multi-drug resistance PA increased from 15.3% to 31.8%.Conclusion：PA is one of the most common pathogens causing nosocomial infection especially for neonates.The sensitivity to antibiotics showed multidrug resistance.In order to reduce or prevent the occurrence of drug resistant strains,we should rationally choose and use antibiotics combining with trait of neonate.