耐亚胺培南铜绿假单胞菌的感染现状及耐药性分析

Current status of imipenem-resistant Pseudomonas aeruginosa infection and analysis of drug resistance

目的探讨医院耐亚胺培南铜绿假单胞菌(PAE)的感染现状及耐药性,为临床医师合理用药提供依据。方法收集医院2008年1月-2010年12月临床分离的128株耐亚胺培南铜绿假单胞菌的感染现状及耐药性进行回顾性分析。结果耐亚胺培南铜绿假单胞菌主要分布在ICU、脑病科、肿瘤科,分别占60.9%、21.9%、8.6%;在各类标本中的检出率以痰液、脓液、创面分泌物较高,分别占60.2%、12.5%、12.5%;耐亚胺培南铜绿假单胞菌对黏菌素B耐药率最低为0,对头孢他啶、阿米卡星耐药率相对较低,为40.62%、46.09%;耐药率>80.0%的有磺胺甲噁唑/甲氧苄啶、头孢噻肟、美罗培南、氨曲南、环丙沙星、庆大霉素、左氧氟沙星;耐药率>50.0%的有哌拉西林、头孢哌酮/舒巴坦、哌拉西林/舒巴坦。结论耐亚胺培南铜绿假单胞菌多药耐药现象极为严重,应加强耐药性监测,合理使用抗菌药物,严防耐亚胺培南铜绿假单胞菌的蔓延。

OBJECTIVE To investigate the infection status and drug resistance of imipenem-resistant Pseudomonas aeruginosa（PAE） causing nosocomial infections,to provide the scientific evidence for rational clinical application of the antibiotics. METHODS From Jan.2008 to Dec.2010,the status and drug resistance of imipenem-resistant P.aeruginosa identified from clinic were retrospectively analyzed. RESULTS Totally 128 strains of imipenem-resistant P.aeruginosa were isolated from the intensive care unit（60.9%）,department of encephalopathy（21.9%）,oncology department（8.6%）.Source of P.aeruginosa mainly came from phlegmy（60.2%）,pyorrhea（12.5%）,secretion（12.5%）.Drug resistance rate of imipenem-resistant P.aeruginosa to polymyxin B can achieve 0,compared to 40.63% and 46.09% to ceftazidime and amikacin.The drug resistance rate80.0% included sulphamethoxazole/trimethoprim,cefotaxime meropenem,aztreonam,ciprofloxacin,gentamicin and levofloxacin.The drug resistance rate50.0% included piperacillin,sulbactan/cefoperazone,piperacillin/tazobactam. CONCLUSION Imipenem-resistant P.aeruginosa isolates are multi-drug resistant.It is important to control bacterial resistance and prevent the spreading of imipenem-resistant P.aeruginosa.