铜绿假单胞菌的临床分布及耐药性分析

Clinical distribution and drug resistance of Pseudomonas aeruginosa

目的了解医院2009年1月-2010年5月铜绿假单胞菌的临床分布及耐药性,为临床合理用药提供依据。方法对医院各种感染标本中分离出的铜绿假单胞菌应用法国生物梅里埃全自动微生物鉴定仪进行鉴定,并做临床常用抗菌药物耐药性分析,用Whonet5.4软件进行统计分析。结果 187株铜绿假单胞菌主要来源于呼吸内科和ICU,分别占39.04%和20.86%;主要来源于痰液,共分离出152株,占81.28%;铜绿假单胞菌对亚胺培南、哌拉西林/他唑巴坦、美罗培南以及阿卡米星对铜绿假单胞菌有较好的抗菌活性,耐药率依次为9.2%、11.3%、16.2%和13.0%;对氨苄西林、氨苄西林/舒巴坦、头孢替坦、呋喃妥因和头孢唑林耐药率>95.00%;对庆大霉素、氨曲南、头孢他啶和头孢吡肟等的耐药率<50.00%。结论医院临床分离的铜绿假单胞菌主要来源于呼吸道感染患者痰液标本中,耐药现象比较严重,加强耐药性检测,以指导临床合理用药控制医院感染。

OBJECTIVE To analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa （PAE） from Jan 2009 to May 2010 so as to provide reference for the clinical reasonable medication. METHODS The identification of P. aeruginosa strains isolated from the hospital was carried out by using full-automatic microbial identification system of BioMfirieux （France）, the drug resistance to common antibiotics was analyzed, and statistical analysis was performed[ by the means of Whonet 5.4 software. RESULTS Among 187 P. aeruginosa isolates, most of them were collected from respiratory department and ICU, accounting for 39.04% and 20.86 %, respectively; totally 152 isolates were isolated from sputum, accounting for 81. 28%. The results of drug susceptibility test revealed that imipenem, piperacillin/tazobactam, meropenem, and amikacin kept high antibacterial activity against PAE, and the resistance rates were 9.2 %, 11.3 %, 16.2 .% and 13.0 %, respectively ; the resistance rates of PAE to Lmpicillin, ampicillin/sulbactam, cefotetan, nitrofurantoin, and cefazolin were higher than 95.00%; the resistance rates to gentamicin, aztreonam, ceftazidime, and cefepime were lower than 50.00%. CONCLUSION The isolated PAE strains are mainly from sputum specimens obtained from patients with respiratory tract infections, and the drug resistance is serious. It is necessary to strengthen the monitoring of drug resistance so as to guide the reasonable use of antibiotics and control nosocomial infections.