2009至2011年铜绿假单胞菌的临床分布及耐药分析

Clinical distribution and drug resistance of Pseudomonas aeruginosa during 2009-2011

目的分析2009至2011年本院临床分离出来的铜绿假单胞菌耐药性的变迁,为临床合理的给药方案提供参考。方法采用肉汤稀释法对临床分离出的2781株病原菌中的252株铜绿假单胞菌对12种抗菌药物进行药敏分析。结果临床上分离铜绿假单胞菌标本主要为痰和支气管灌洗液下呼吸道标本,占62.3%(157/252)。铜绿假单胞菌感染发生率主要分布在ICU 27.8%(70/252)和感染科19.8%(50/252)。铜绿假单胞菌对大多抗菌药物的耐药性逐年增加,尤其亚胺培南和美洛培南已经达到41%(30/74)和35%(22/74),敏感性最高的为多粘菌素B和氨基糖苷类阿米卡星。结论铜绿假单胞菌感染有上升趋势,对常用抗生素耐药率增加,需引起临床重视。加强其耐药监测可以为临床提供治疗依据。

Objective To analyze the antibiotic resistance of Pseudomonas aeruginosa （PA） during 2009-2011 and provide useful reference for rational clinical medication of PA. Methods Susceptibility rate of 12 antibiotics against 252 strains of PA were determined by broth dilution method. Results Tatal of the 252 clinical strains of P. aeruginosa, 62.3% cases （157） were isolated from respiratory tract. The infection of P.aeruginosa occurred frequently in Intensive Care Units （ICU） and the department of infectious disease, which accounted for 31.6% and 20.2%, respectively. The resistance rate of PA to most antimicrobial agents have increased by year, including Imipenem and Meropenem （41% and 35%, respectively）. Polymyxin B and Amikacin had the best sensitity to P. aeruginosa. Conclusions The infection rate of Pseudomonas aeruginosa has increased during the last three years and has become more resistant to commonly used antibiotics, so it needs more clinical attention. To strengthen its resistance monitoring would provide evidence for treatment of PA in clinical practice.