院内获得性绿脓杆菌感染对抗生素敏感性的研究

The Antibiotics Sensitivity of In-hospital Acquired Infection of Pseudomonas Aeruginosa

目的探讨院内获得性绿脓杆菌感染特点及目前常用多种抗生素的耐药性。方法收集2009年10月～2011年5月呼吸内科合并肺绿脓杆菌感染病例117例(其中47例气管插管或气管切开接受机械通气)痰培养标本,应用微生物自动分析仪对绿脓杆菌共457株进行鉴定及药物敏感试验。结果引起院内获得性绿脓杆菌感染的457株绿脓杆菌对13种常用抗生素的平均耐药率>30%,对阿米卡星耐药率<30%,对喹喏酮类耐药率接近30%,对β-内酰胺类和头孢菌素类抗生素耐药率较高。结论治疗院内获得性绿脓杆菌感染,β-内酰胺酶类联合氨基糖甙类或喹诺酮类为较优化的组合;对MDR-PA可首选头孢哌酮舒巴坦与阿米卡星联合或头孢哌酮舒巴坦与环丙沙星联合。

Objective To conduct clinical analysis of in-hospital acquired Pseudomonas aeruginosa infection and study multiple its drug resistance to antibiotics. Methods Collected 117 cases （ of which 47 tracheal intubation or receiving mechanical ventilation ） with Pseudomonas aeruginosa infection between October 2009 to May 2011. Cultivated sputum specimen ,identified and performed drug sensitive test to 457 strains of Pseudomonas aeruginosa with microorganism analyzer. Results Four hundred ane fifty-seven strains of Pseudomonas aeruginosa that cause in- hospital acquired infection of Pseudomonas aeruginosa to 13 kinds of common antibiotics resistance rate on average 〉 30%, amikacin resistance rate 〈 30%, on chloroquine ketones resistance was close to 30% for beta-lactam and cephalosporin class antibiotics resistance rate was higher. Conclusion The treatment of in-hospital acquired infection of Pseudomonas aeruginosa,β -lactamase United aminoglycoside or quinolone classes are optimized combination; MDR-PA preferred cefoperazone sodium and sulbactam sodium combined with amikacin or ciprofloxacin cefoperazone and sulbactam.