某院2010—2012年铜绿假单胞菌的分布情况及耐药性分析

Analysis of Clinical Distribution and Drug Resistance of Pseudomonas Aeruginosa(2010—2012)

目的分析铜绿假单胞菌在我院医院内感染中的分布情况及其对14种常用抗生素的耐药情况,为临床合理选用抗生素提供依据。方法使用常规方法对我院2010年10月—2012年3月临床送检标本进行分离培养,采用VITEK-2全自动生物鉴定仪对细菌进行鉴定,K-B法进行药物敏感试验。结果共分离出铜绿假单胞菌1862株,在痰液分离率最高,其他依次为伤口分泌物拭子、脓液、血液、尿液、脑脊液。铜绿假单胞菌感染主要分布在呼吸科、干部病房、神经外科及重症监护病房。本组菌株对氨苄西林、氨苄西林钠-舒巴坦钠、头孢唑林钠、复方磺胺甲口恶唑、庆大霉素、哌拉西林钠-他唑巴坦钠、环丙沙星及左氧氟沙星的耐药率较高,其中对氨苄西林、氨苄西林钠-舒巴坦钠及头孢唑林钠的耐药率在90.00%以上。结论铜绿假单胞菌已经成为医院内感染的重要病原菌,易产生多重耐药。合理使用抗生素,严格控制医院内感染,加强细菌耐药性监测,可减少耐药菌株的产生与扩散。

Objective To analyze the clinical distribution and drug resistance of pseudomunas aeruginosa for 14 kinds of commonly used antibiotics in our hospital in order to provide evidence for rational use of arttihiotics. Methods Fractional cultivation was performed in various clinical samples in our hospital with routine methods during October 2010 and March 2012. bacterial identifieation was performed by VITEK-2 auto-biological assay machine and drug sensitivity test was carried out by Kirby-Bauer method. Results 1862 strains of pseudomonas aeruginosa were isolated. The isolating rate of sputum was the highest, tollowed by wound secretion swabs, pus, blood, urine and eerebrospinal fluid. Most of pseudomonas aeruginosa were dispersed in pneumology department, cadre wards, neurosurgery department and ICU. Pseudomonas aeruginosa was highly resistant to ampieillin, ampicillin sodium-sulbactam sodium, cefazulin sodimn, compound sulfamethoxazole, gentamiein, piperacillin sodium-tazobactam sodium, ciprofloxaein and levotloxacin, among them ampicillin, ampicillin sodium-sulhactam sodium and cefazolin sodium was over 90%. Conclusion Pseudomonas aeruginosa is a major iatrogenic pathogenic bacteria, and can easily produce multi-resistance. We should control the use of antibiotics, control hospital intection and strengthen detection of bacterial drug resistance so as to reduce production and diffusion of drug resistant strains. [ Key wordsl