神经外科病房铜绿假单胞菌耐药性监测

Monitoring of drug resistance of pseudomonas aeruginosa in patients in Neurosurgery Ward

目的了解2008年10月至2009年10月神经外科监护病房患者铜绿假单胞菌的药敏及耐药性,为临床合理使用抗生素提供依据。方法菌种经珠海DLMedcal-96细菌测定系统进行鉴定,及该系统肠杆菌属随机体外诊断试剂板进行药敏试验,并作统计分析。结果本院神经外科病房共检出264株病原菌,其中铜绿假单胞菌分离出92株34.85%(92/264),为第一病原检出菌。铜绿假单胞菌对21种抗生素耐药较低的依次为头孢他啶、亚胺培南、美罗培南(均为6.52%)、粘菌素、多粘菌素B(均为8.70%)、左氧氟沙星(17.39%)、头孢吡肟(21.74%)、环丙沙星、氨曲南(均为23.91%)、哌拉西林/他唑巴坦(26.09%)、头孢哌酮/舒巴坦(30.43%)、头孢噻肟(36.96%)。耐药较严重的抗生素为氯霉素(86.96%)、复方新诺明(95.65%)。结论临床应重视药敏试验结果,并及时对耐药结果统计分析,严格控制抗菌药物的使用。

Obiective To investigate the sensitivity and drug resistance of pseudomonas aeruginosa to antibiotics in patients in Neurosurgery Ward of our hospital from October 2008 to October 2009,and to offer reference for rational use of antibiotics.Methods The bacteria was identified by DLMedical-96 bacteria identification system and Kirby-Bauer（k-B） method was used for susceptibilty test.Results A total of 264 strains of bacteria were isolated,in which 92 strains（34.85%） were pseudomonas aeruginosa.The more sensitive antibotics to peseudomonas aeruginosa were as follows：ceftazidime,imipenem and meropeneum（resistance rate 6.52%）,colistin,polymyxin B（resistance rate 8.70%）,levofloxacin（resistance rate 17.39%）,cefepime（resistance rate 21.74%）,ciprofloxacin and aztreonam（resistance rate 23.91%）,cefepime and piperacilln-tazobactam（resistance rate 26.09%）,cefoperazone/sulbactam（resistance rate 30.43%） and cefotaxime（resistance rate 36.96%）.The antibiotics with high drug resistance were chloramphenicol（resistance rate 86.96%） and compound sulfamethoxazole（resistance rate 95.65%）.Conclusion Drug susceptibility test should be paid more attention to and drug resistance results should be statistically analyzed timely.It is tmportant to use antibacterials rationally in the clinic.