海岛地区铜绿假单胞菌的临床分布与耐药性分析

Clinical distribution and drug resistance of Pseudomonas aeruginosa isolated from island areas

目的了解医院铜绿假单胞菌的分布及耐药性。方法临床标本经24h分离培养,采用BD公司Phoe-nix-TM100全自动细菌鉴定仪及配套的鉴定板,对菌株进行鉴定和药敏试验。结果 142株铜绿假单胞菌中96株来源于痰液,占67.6%;铜绿假单胞菌对头孢噻肟、头孢曲松、头孢他啶耐药率分别98.6%、100.0%、76.8%,对其他β-内酰胺类抗菌药物如头孢吡肟、哌拉西林/他唑巴坦、哌拉西林耐药率分别为73.3%、78.9%、80.3%,对亚胺培南的耐药率为32.4%,对阿米卡星的耐药率最低,为10.6%。结论铜绿假单胞菌是医院感染的主要致病菌之一,其耐药机制复杂;临床治疗铜绿假单胞菌感染时,应选用耐药率低的药物,避免诱导铜绿假单胞菌产生β-内酰胺酶而广泛耐药。

OBJECTIVE To investigate the distribution and drug resistance of Pseudomonas aeruginosa. METHODS All specimens isolated and cultured from patients were identified by using the automatic microorganism analyzer Phoenix-TM100 which was made by BD company, and the drug susceptibility testing and the identification were performed for the isolated strains by using Microscan Panel. RESULTS Among 142 strains of P. aeruginosa, 96 （67. 6%） strains came from sputum; the resistance rates of P. aeruginosa to cefotaxime, ceftriaxome, and ceftazidime were 98.6%, 100.0%, and 76.8%, respectively, the resistance rates to other β-lactamases antibiotics such as eefepime, piperacillin/tazobaetam, and piperacillin were 73.3 %, 78.9 % , and 80.3 %, respectively, the resistance rate to imipenem was 32. 4%, and the resistance rate to amikacin was the lowest （10. 6%）. CONCLUSION P. aeruginosa is one of the main pathogens causing nosocomial infections, and drug resistant mechanism of P. aeruginosa is very complex; in response to P. aeruginosa infections, the antibiotics should be selected according to low drug-resistant rate in order to avoid β-1actamases induced by P. aeruginosa.