多药耐药铜绿假单胞菌医院感染现状与耐药性探讨

Current status of nosocomial infections caused by multidrug-resistant Pseudomonas aeruginosaand investigation of drug resistance

目的探讨医院多药耐药铜绿假单胞菌(MDRPA)的医院感染现状和耐药特性,为临床医师选择使用抗菌药物提供科学依据。方法铜绿假单胞菌的标本采集、培养与鉴定严格按照《全国临床检验操作规程》,采用常规方法进行;用CLSI推荐的纸片扩散法进行药敏试验操作和结果判断。结果医院临床分离的135株MDRPA在呼吸道标本中检出率最高,占54.8%;泛耐药株占10.4%;MDRPA对亚胺培南、美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦等广谱高效抗菌药物已产生了10.4%～15.6%的耐药率,对其他常用抗菌药物的耐药率均>40.0%,耐药率最高的抗菌药物是磺胺甲噁唑/甲氧苄啶为80.0%。结论医院务必采取切实有效的干预对策,遏制细菌耐药性快速增长的不良趋势。

OBJECTIVE To investigate the status and antibiotic resistance of nosocomial infection caused by multidrug-resistant Pseudomonas aeruginosa（MDRPA） and provide the scientific evidence for clinical use of the antibiotics.METHODS Referring to National Guide to Clinical Laboratory Procedures,specimen collection,bacterial culture and identification of P.aeruginosa were performed by routine method.The susceptibility test was performed by K-B method recommended by CLSI.And the testing results were assessed.RESULTS Among 135 clinical isolates of MDRPA,the highest detection rate was in respiratory tract specimen（accounted for 54.8%）.The pan-resistant strains accounted for 10.4%;the resistance rates of MDRPA to imipenem,meropenem,piperacillin/tazobactam and cefoperazone/sulbactam varied from 10.4% to 15.6%.Resistance rates to other common antibiotics were all above 40.0%,and the resistance rate to SMZ/TMP was the highest（80.0%）.CONCLUSION The effective intervention should be adopted to restrain the rapidly increasing tendency of antimicrobial resistance.