铜绿假单胞菌科室分布及耐药性分析

Analysis of Distribution in Departments and Drug Resistance of Pseudomonas Aeruginosa

目的了解铜绿假单胞菌,尤其耐亚胺培南铜绿假单胞菌的科室分布及耐药情况,为临床合理选用抗菌药物提供依据。方法应用回顾性调查方法,对我院2009—2011年临床送检标本中分离的1053株铜绿假单胞菌药敏试验结果进行统计分析。结果标本分离的铜绿假单胞菌主要来自重症医学科、呼吸内科、神经外科和急诊科,痰液标本中铜绿假单胞菌分离率最高,为82.5%(869/1053),耐亚胺培南铜绿假单胞菌菌株分离率达22.2%。耐亚胺培南菌株除对头孢哌酮钠、阿米卡星和哌拉西林钠-他唑巴坦钠耐药率<40.0%外,对头孢他啶、庆大霉素、妥布霉素、哌拉西林钠和头孢吡肟耐药率均>40.0%,对氨曲南、头孢噻肟钠、头孢曲松钠、环丙沙星、左氧氟沙星和亚胺培南-西司他汀钠耐药率为57.7%～100%;非耐亚胺培南铜绿假单胞菌对头孢曲松钠、头孢噻肟钠、环丙沙星和左氧氟沙星敏感性降低,耐药率为32.4%～44.8%,对其他抗菌药物的敏感性较强,耐药率≤21.2%。神经内科未分离出耐亚胺培南铜绿假单胞菌。结论耐亚胺培南铜绿假单胞菌菌株分离率较高,临床医生应关注各种抗菌药物的耐药谱变化,根据药敏结果合理选用抗菌药物。

Objective To investigate the distribution in different departments and drug resistance of Pseudomonas aeruginosa（PAE） and imipenem-resistant Pseudomonas aeruginosa（IRPA） so as to provide evidence for the rational use of antibiotics.Methods The results of drug susceptibility tests of 1053 PAE isolated samples during 2009 to 2011 were retrospectively analyzed by survey methods.Results PAE was mainly found in ICU,departments of respiratory diseases,neurosurgery and emergency rooms.The isolating rates of PAE in sputum specimens（82.5%） were the highest（869/1053）,and the rate of IRPA was 22.2%.The resistance rates of imipenem-resistant strains to Cefoperazone Sodium,Amikacin,Piperacillin Sodium and Tazobactam Sodium were less than 40.0%,but the rates to Ceftazidime,Gentamicin,Tobramycin,Piperacillin,and Cefepime was over 40.0%,and the rates to Aztreonam,Cefotaxime sodium,Ceftriaxone sodium,Ciprofloxacin,Levofloxacin,Imipenem and Cystatin Superfamily were between 57.7% to 100%.The susceptibility rate of Non-IRPA（32.4%~44.8%） to Ceftriaxone sodium,Cefotaxime sodium,Ciprofloxacin and levofloxacin were lower,rates to other antimicrobial drugs（≤21.2%） were higher.IRPA was not found in the department of neurology.Conclusion IRPA strains have higher isolating rates,and clinicians should pay attention to changes of resistance spectrum in various antimicrobial drugs so as to appropriately use antimicrobial drugs.