呼吸内科住院患者540株铜绿假单胞菌耐药性分析

Antibiotic resistance of Pseudomonas aeruginosa causing secondary pneumonia in patients in the Department of Respiratory Medicine

目的了解医院呼吸内科患者继发感染铜绿假单胞菌(PAE)的耐药性,为临床合理用药提供依据。方法对2008～2010年呼吸内科病区各类标本中分离的PAE的耐药情况进行回顾性研究。自动微生物分析仪(VITEK-AMS)进行PAE菌株鉴定,药敏试验采用纸片扩散法(K-B法)。结果分离出的540株PAE中,2008年151株,2009年186株,2010年203株,痰标本分离PAE最多(511株)。PAE对阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率较低,耐药率分别为15.19%、22.04%和28.33%,对头孢呋辛、氨苄西林、头孢拉定的耐药率分别达到了94.26%、92.41%和86.85%;亚胺培南耐药率2008年为27.81%,2010年为38.92%,增长较快;PAE泛耐药株检出率为9.44%。结论呼吸内科PAE耐药情况严重;抗感染治疗时应根据药敏结果合理选择药物。

Objectives To determine the antibiotic resistance of Pseudomonas aeruginosa （PAE） causing pneumonia inpatients in the Department of Respiratory Medicine and to facilitate the rational use oi antibiotics, Methods The drug resistance of PAE strains isolated from samples from patients in the Department of Respiratory Medicine from 2008 to 2010 was retrospectively analyzed. PAE strains were cultured and identified with the VITEK-AMS. Antibiotic suscepti bility testing was performed using the K-B method. Results of 540 strains of PAE, 151 were isolated in 2008, 186 were isolated in 2009, and 203 were isolated in 2010. The rates of resistance to amikacin, cefoperazone-sulbactam, and piperacillin-tazobactam were relatively low （15.19%, 22.04%, and 28.33%, respectively）. The rates of resistance to cefuroxime, ampicillin, and cefradine were as high as 94.26%, 92.41%, and 86.85%, respectively. The rate of resistance to imipenem increased substantially, from 27.81% in 2008 to 38.92% in 2010. In addition, the rate of detection of pan resistant strains was 9.44%. Conclusion PAE causing pneumonia in patients in the Department of Respiratory Medi- cine was highly resistant to antibiotics. Susceptibility should be examined so that appropriate antibiotics can be chosen.