医院内感染多重耐药铜绿假单胞菌耐药性分析及预防对策

Analysis of drug resistance and preventive measures in multi-drug resistant Pseudomonas aeruginosa of nosocomial infection

目的了解铜绿假单胞菌临床分离株的多重耐药情况,为临床抗感染治疗及医院内感染监控提供实验依据。方法采用美国DADE公司生产的MicroScan WalkAway-96全自动细菌分析系统,对临床分离菌进行菌种鉴定,同时对常用抗菌药物进行MIC测定。结果共分离铜绿假单胞菌762株,其中多重耐药铜绿假单胞菌239株,占31.4%。多重耐药铜绿假单胞菌主要集中在ICU、呼吸科和烧伤科病房,分别占31.8%、22.2%和19.7%;标本主要来源于下呼吸道的痰标本,占59.0%,其次为创面分泌物,占20.9%;多重耐药铜绿假单胞菌对头孢哌酮/舒巴坦的耐药率最低(38.6%),其次为美罗培南(43.7),对其他抗菌药物的耐药率大多在60%以上。结论多重耐药铜绿假单胞菌分离率较高,多重耐药性明显,临床应加强其耐药性监测及预防管理,以减少多重耐药菌的产生和扩散。

Objective Understanding of multi-drug resistant Pseudomonas aeruginosa clinical isolates to provide experimental basis for clinical anti-infection treatment and hospital infection control.Methods Application of MicroScan WalkAway-96automatic bacterial identification system,simultaneous determination of the commonly used antimicrobial agents against clinical isolates were identified by MIC.Results 762strains of Pseudomonas aeruginosa were isolated in total,of which 239strains of multi-drug resistant accounted for 31.4%..Multi-drug resistant Pseudomonas aeruginosa is mainly in the ICU,Department of Respiration and burn unit,respectively accounted for 31.8%,22.2%and 19.7%.Specimens come mainly from sputum samples of the lower respiratory tract accounting for 59.0%,followed by wound secretion,accounting for 20.9%.Multi-drug resistant Pseudomonas aeruginosa resistance rate to cefoperazone / sulbactam（38.6%）,followed by meropenem（43.7%）,the other antimicrobial resistance rates were above 60%.Conclusion Multidrug-resistant Pseudomonas aeruginosa high separation rate,multi-drug resistance obvious clinical should strengthen its monitoring of drug resistance and prevention of management,to reduce the emergence and spread of multi-drug resistant.