2008-2009年医院感染铜绿假单胞菌的耐药性分析

Drug resistance of Pseudomonas aeruginosa causing nosocomial infection from 2008 to 2009

目的对医院感染的重要病原菌及其耐药性做定期分析,为临床合理选用抗菌药物及控制医院感染提供依据。方法对医院2008-2009年临床标本中分离出的202株铜绿假单胞菌的耐药性进行回顾性对比分析。结果 15种抗菌药物中,2009年有9种抗菌药物的耐药率比2008年均有不同程度提升,提升较为明显的有:环丙沙星由2008年的17.05%升至2009年的27.19%,头孢曲松由68.18%升至95.61%,头孢他啶由19.32%升至30.70%,头孢吡肟由25.00%升至31.58%,氨曲南由34.09%升至41.23%,哌拉西林/他唑巴坦由20.45%升至25.44%;2009年ICU的耐药率明显高于非ICU:亚胺培南、哌拉西林/他唑巴坦、环丙沙星、氨曲南、头孢他啶、左氧氟沙星及头孢吡肟在两病区之间差异均有统计学意义(P<0.01)。结论铜绿假单胞菌的多药耐药株呈逐年增加趋势,尤其是对碳青霉烯类抗菌药物耐药率的提升,应引起临床高度重视。

OBJECTIVE To regularly analyze the major pathogenic bacteria causing nosocomial infections and their antibiotic resistance so as to contribute to reasonable use of antibiotics and control of nosocomial infections. METHODS A total of 202 Pseudomonas aeruginosa strains isolated from linieal speciraens in 2008 and 2009 were retrospectively compared and analyzed . RESULTS Among the 15 kinds of antibiotics tested, the drug resistance for 9 antibiotics had significantly increased in varying degrees from 2008 to 2009, including ciprofloxacin increasing from 17.05% to 27.19%, ceftriaxone from 68.18% to 95.61%, ceftazidime from 19.32% to 30.70%, cefepime from 25.00% to 31.58%, aztreonam from 34.09% to 41.23%, and piperacillin/tazobactam from 20. 45% to 25.44%% the drug resistance rates of ICUsisolated pathogens were significantly higher than nonICUsisolated pathogens, the differences of the drug resistance rates to imipenem, piperacillin/tazobactam, ciprofloxacin, aztreonam, ceftazidime, levofloxacin, and cefepime between JCUsisolated pathogens and nonICUsisolated pathogens were statistically significant （P〈0.01）. CONCLUSION The multidrugresistant Pseudomonas aerugi nosa isolates increase year by year, it is necessary to pay more attention to the increasing drug resistance for carbaDenems antibiotics.