老年病房三年铜绿假单胞菌的感染分布及耐药性变迁

Distribution of Pseudomonas aeruginosa Infection and Antimicrobial Resistance Change in Geriatric Wards from 2008 to 2010

目的了解2008-2010年老年病房患者感染铜绿假单胞菌耐药性变迁,为临床合理使用抗菌药物提供依据。方法采用法国生物梅里埃公司的VPI微生物自动鉴定系统,对2008-2010年老年病房住院患者的各类临床标本进行细菌分离、鉴定,药敏试验采用纸片扩散法检测头孢他啶等15种抗生素敏感性,并对药敏结果进行分析。结果 2008-2010年老年病房患者感染铜绿假单胞菌分离率分别为10.46%、15.07%、18.92%,3年均以老年呼吸内科检出率最高,标本分布以痰液为主,该菌在三年中对常用药物耐药率呈明显上升趋势。但铜绿假单胞菌对抗菌药物的耐药率小于30%的药物有亚胺培南、多粘菌素、阿米卡星。结论重视铜绿假单胞菌耐药性变迁的抗菌药物压力和减少该菌感染的危险因素,是有效防止该菌耐药性增高和耐亚胺培南铜绿假单胞菌产生的关键。

Objective To understand the distribution of Pseudomonas aeruginosa infection and its drug resistance change in geriatric wards during the period of 2008～2010,and to provide a basis for rational use of antimicrobial agents in clinical practice. Methods The clinical samples were collected from the patients in geriatric wards from 2008 to 2010.The bacteria were cultured,isolated,and identified with API 20C AUX identification system.Drug sensitivity to 15 kinds of antibiotics were tested by disk diffusion method and the results were analyzed Results The isolation rates of Pseudomonas aeruginosa of geriatric wards in 2008,2009,and 2010 were 10.46%,15.07%,and 18.92%,respectively.The detection rates of Pseudomonas aeruginosa of respiratory diseases department in 2008,2009,and 2010 were the highest,and it mainly distributed in the sputum specimens.The resistant rates of Pseudomonas aeruginosa to the commonly used antibiotics showed a significant increasing tendency during the there years.But the resistant rates of Pseudomonas aeruginosa to imipenem,polymyxin and amikacin were all below 30.0%. Conclusions Emphasis on the resistance changing of Pseudomonas aeruginosa to antibiotics and reduction of risk factors for Pseudomonas aeruginosa infection are the key points in effectively decreasing the drug resistance and imipenem-resistant Pseudomonas aeruginosa.