428株铜绿假单胞菌的临床分布与耐药性分析

Clinical Distribution and Drug Resistance of 428 strains Pseudomonas aeruginosa

目的分析临床分离铜绿假单胞菌的感染部位分布及耐药率,为减少和控制院内感染及临床合理选择抗菌剂提供依据。方法采用法国生物梅里埃公司ATB Expression微生物分析仪进行细菌鉴定,K-B纸片扩散法进行药敏试验。结果分离获得1 165株细菌,其中铜绿假单胞菌428株,检出率为36.74%;82.00%的铜绿假单胞菌分离自痰与咽拭子,41.44%分离自干部病区。铜绿假单胞菌菌株对多黏菌素B敏感率最高(100.00%),其次为美罗培南(59.80%)、哌拉西林/他唑巴坦(59.70%)和亚胺培南(57.10%)。结论铜绿假单胞菌临床检出率较高,主要分布在老干部病区。易感因素为患者病情严重、住院时间较长、免疫功能低下、大量使用抗菌剂等。铜绿假单胞菌表现为高度和多药耐药,建议临床应根据药敏试验结果进行抗感染治疗。

Objective To explore the distribution and drug resistance of clinical isolates of Pseudomonas aeruginosas to provide reference for the prevention of hospital onset of infection and clinical rational drug use.Methods ATB Expression system was used to identify Pseudomonas aeruginosas,and antimicrobial resistance was determined by Kirby-Bauer method.Results Among the 1 165 clinical isolates,428 strains（36.74%） were Pseudomonas aeruginosa.82.00% of Pseudomonas aeruginosa were separated from the sputum.The antibiotic sensitive rates to PB,MEM,TZP,IPM were 100.00%,59.80%,59.70%and 57.10%.Conclusion The detection rate of Pseudomonas aeruginosa was higher than other clinical isolates.The infection risk factors maybe include the severity of diseases,the length of stay in hospital,the immune function and long-term use of antibiotic.Pseudomonas aeruginosa could be highly resistant to antibiotics with multidrug resistance.Antimicrobial agents should be chose more carefully according to the antimicrobial susceptibility test.