2003-2007年铜绿假单胞菌感染分布及耐药性变迁

Distribution of Pseudomonas aeruginosainfection and change of drug resistance 2003-2007

目的分析铜绿假单胞菌对多种抗菌药物耐药性的动态变迁以及感染病例科室分布,为临床合理治疗提供可靠依据。方法 2003-2007年,从临床标本中分离703株铜绿假单胞菌(PAE),用K-B扩散法进行药敏试验,根据美国NCCLS制定的标准判读结果。结果 2006年和2007年的PAE分离率上升为第1位;703株PAE主要从痰及咽拭子标本中检出占78.9%;ICU的检出率最高,占41.0%;药敏结果显示头孢他啶、头孢曲松、头孢哌酮、头孢吡肟、阿米卡星抗菌活性最强,而头孢唑林、氨苄西林、阿莫西林、氯霉素、磺胺甲噁唑/甲氧苄啶和亚胺培南的耐药率>70.0%。结论 PAE感染对抗菌药物耐药率有逐年增高趋势,各科室的感染情况有明显的差别,且多表现为多药耐药,通过对PAE的分布及耐药性进行监测,为临床科学合理地使用抗菌药物,并进行有效地控制PAE感染,具有十分重要的意义。

OBJECTIVE To study the dynamic changes of drug resistance and distribution of Pseudomonas aeruginosa（PAE） infection,and to provide experimental evidence for clinical rational drug use.METHODS The susceptibility to antibiotics were detected in 703 strains of PAE,and its antimicrobial resistance was determined by Kirby-Bauermethod system.RESULTS The infectious distribution of PAE was increased during the five years.The most PAE strains were cultured from the infection of sputum and throat mucus（78.9%）;the most infection caused by PAE happened in department for Intensive Care Units（ICU）（41.0%）;the result of drug susceptibility showed that PAE had a higher susceptibility to ceftazidine,rocephin,cefoperazone,cefepime,amikacin,but highly resistant to cefazolin,ampicillin,amoxicillin,chloroamphenicol,paediatric and imipenem with the resistance rates〉 70.0%.CONCLUSION The drug resistance of PAE has become a more serious problem than before and it should perform rigorous monitoring.It′s very important to use drugs rationally according to the drug resistance and infectious distribution.