铜绿假单胞菌的分布及耐药分析

Distribution and Antibiotic-resistance Analysis of Pseudomonas Aeruginosa

目的:分析江汉大学附属医院病人铜绿假单胞菌的耐药率,指导临床用药.方法:对2009年1月-2010年12月临床分离的138株铜绿假单胞菌进行回顾性分析,采用WHONET5.4软件统计耐药率.结果:铜绿假单胞菌在呼吸道标本中的检出率最高,占86.9%;对阿米卡星(87.0%)、头孢哌酮/舒巴坦(83.8%)、头孢吡肟(79.4%)的敏感性较高,其次为头孢他啶(76.3%)、氨曲南(68.5%);而耐药性较高的抗生素有头孢噻肟(86.4%)、左氧氟沙星(32.8%).结论:由于铜绿假单胞菌的特殊耐药机制及广谱抗生素的广泛应用,铜绿假单胞菌的耐药率呈增加趋势,并出现多重耐药的现象,单种抗生素常不能治愈感染.因此早期抗生素联合用药,同时加强对细菌的耐药监测和药敏分析,是避免铜绿假单胞菌耐药加快的有效办法.

Objective：To analyse the drug resistance rate of Pseudomonas aeruginosa in the Affiliated Hospital of Jianghan University,to provide direction for clinical drug application.Methods：To analyse the drug resistance of 138 cases which clinically isolated Pseudomonas aeruginosa from Jan.,2009 to Dec.,2010,and obtained the rate of antibiotic-resistance by WHONET5.4 software.Results：The highest detection rate of Pseudomonas aeruginosa came from the specimen of respiratory tract,which was 86.9%;These Pseudomonas aeruginosa were more sensitive to amikacin（87.0%）、sulbactam and cefopcrazone（83.8%）,cefepime（79.4%）,and then to ceftazidime（76.3%）,aztreonam（68.5%）;the resistance rates of Pseudomonas aeruginosa to cefotaxime（86.4%）,levofloxacin（32.8%）were higher than other antibiotics.Conclusion：For the special drug-fast mechanism of Pseudomonas aeruginosa and the wide use of the broad-spectrum antibiotic,the resistance rate of Pseudomonas aeruginosa to antibiotic is higher and higher,and there are samples of Pseudomonas aeruginosa which are multi-drug-resistance,the infection always can not be cured by single antibiotic.The most effective method for preventing the fast development of resistance of Pseudomonas aeruginosa to antibiotic is early drug combination,strengthening the monitoring to the resistance rate of Pseudomonas aeruginosa,and analysis of drug sensitive test.