老年患者肺部感染铜绿假单胞菌的耐药性探讨

Antibiotic resistance of Pseudomonas aeruginosacausing pulmonary infections in senile patients

目的探讨老年患者肺部感染铜绿假单胞菌(PAE)的耐药性,为临床预防及控制感染提供科学依据。方法细菌培养鉴定按照《全国临床检验操作规程》进行;药物敏感试验和结果判断采用CLSI推荐的K-B法进行。结果 142株老年肺部感染PAE,对常用抗菌药物产生了多药耐药性,甚至对碳青霉烯类抗菌药物亚胺培南和美罗培南产生了3.5%的耐药率;对氨曲南、头孢噻肟、左氧氟沙星、环丙沙星耐药率均>50.0%,对庆大霉素、头孢吡肟、头孢曲松耐药率均>40.0%;而对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星等抗菌药物敏感率较高为79.6%～86.6%。结论医院老年患者肺部感染PAE耐药性已十分严峻,应采取综合性预防与控制措施,遏制PAE耐药性逐年上升的趋势。

OBJECTIVE To analyze antimicrobial resistance of Pseudomonas aeruginosa（PAE） causing pulmonary infections in senile patients and provide the scientific evidence for clinical prevention and control of infections.METHODS Referring to National Guide to Clinical Laboratory Procedures,the strains were cultured and identified.The antibiotic susceptibility testing was performed using K-B method recommended by CLSI,and the testing results were assessed.RESULTS Totally 142 isolates of PAE causing senile pulmonary infections were multidrug-resistant to commonly used antibiotics.3.5% of PAE were resistant to carbapenems such as imipenem and meropenem.The resistance rates to aztreonam,cefotaxime,levofloxacin and ciprofloxacin were all above 50.0%.The resistance rates to gentamycin,cefepime and ceftriaxone were all above 40.0%.The susceptibility rates to cefoperazon/sulbactam,piperacillin/tazobactam,amikacin,et al.were higher,varying between 79.6% and 86.6%.CONCLUSION The drug resistance of PAE causing pulmonary infections in senile patients is very serious.The comprehensive prevention and control measures should be adopted to restrain the increasing tendency of antimicrobial resistance year by year.