2008-2010年ICU铜绿假单胞菌的分布及耐药性分析

Distribution and drug resistance of Pseudomonas aeruginosa in ICU during 2008-2010

目的调查医院ICU铜绿假单胞菌医院感染的分布与耐药现状,为临床医师合理用药提供科学依据。方法应用回顾性调查方法,对医院ICU 2008-2010年临床送检标本中分离出的铜绿假单胞菌及药敏结果进行统计分析。结果 2008-2010年分离率分别为14.6%、10.0%、7.9%,分离率有所下降;125株铜绿假单胞菌在呼吸道标本中分离率最高,占74.4%;其次是血液感染,占8.0%;铜绿假单胞菌耐药率<40.0%的抗菌药物有亚胺培南、头孢哌酮/舒巴坦、阿米卡星,耐药率>80.0%的有头孢呋辛、头孢噻肟、头孢曲松、哌拉西林、庆大霉素、妥布霉素、氯霉素,多药耐药菌株检出率达63.2%。结论 ICU铜绿假单胞菌耐药性比较严重,且具有多药耐药性,应加强监测与控制。

OBJECTIVE To investigate distribution and drug resistance status of Pseudornonas aeruginosa （PAE） causing nosocomial infections in ICU so as to provide the scientific reference for clinically reasonable use of antibiotics. METHODS Retrospective survey and statistical analysis were carried out for PAE isolated from ICU from Jan 2008 to Dec 2010 and the drug susceptibility testing. RESULTS The isolation rates of PAE during 2008- 2010 were 14.6 %, 10.0%, and 7.9 %, respectively, tended to decrease; among 125 PAE strains, the isolation rate in the lower respiratory tract samples was the highest （74.4M）, followed by the blood samples （8.0%） ; the resistant rates of PAE to imipenem, cefoperazone sulbactam, and amikacin were below 40. 0%; the drug resistance rates to cefuroxime, cefotaxime, ceftriaxone, piperacillin, gentamycin, tobramycin, and chloromycetin were higher than 80.0%, the detection rate of multiple drug-resistant strains reached to 63.2%. CONCLUSION Drug resistance of PAE from ICU is very serious with multidrug-resistance, it is necessary to strengthen the monitoring and cont＇rol of drug resistance.