心血管内科病房感染患者铜绿假单胞菌的分离与耐药性分析

目的了解医院心血管内科感染患者铜绿假单胞茵耐药谱的变化，指导临床合理用药。方法收集2011年1月至2013年6月心血管内科送检的感染患者标本．分离铜绿假单胞茵，分析各类标本分离的铜绿假单胞菌构成比；采用MieroSeanNC31、NC33鉴定药敏复合板进行鉴定和药敏试验，按美国·播床实验室标准化委员会（CLSI）标准对常用的14种抗生素进行耐药性分析。结果共分离出102株铜绿假单胞菌，主要来源于痰液，占70．5％。PAE对加替沙星、头孢他啶、哌拉西林他唑巴坦的敏感率分别为100％、83-2％、80．8％；对头孢噻肟、头孢曲松的敏感率为7．4％、7-2％；对庆大霉素、头抱吡肟、左旋氧氟沙星、环丙沙星、替卡西林克拉维酸、哌拉西林、亚胺培南、妥布霉素的敏感率为56．2％～74．7％。在14种抗菌药物药敏试验中，加替沙星的敏感率为100％，对头孢噻肟、头孢曲松的敏感率上升，其它12种药物敏感率均明显下降。血液中PAE标本对除哌拉西林他唑巴坦以外的13种抗茵药的敏感率均明显比痰中PAE敏感率低。结论铜绿假单胞菌耐药现象严重，心血管内科应注意铜绿假单胞菌耐药性的监测。

Objective To analyze the change of resistance spectrum of Pseudomo as aeruginosa in infectious patients in Cardiovas- cular Medicine Ward,and to help the correct use of drugs.Methods P.aeruginosa strains from Cardiovascular Medicine Ward were collected between January 2011 and June 2013.The constituent ratio and the resistance status of the P.aeruginosa strains were an- alyzed.MicroScan NC31 ,NC33 composite board were used to the identification and drug sensitive test,the resistance spectrum of P. aeruginosa to 14 common antibacterials were analyzed according to CLSLResults A total of 102 strains of P.aeruginosa were mainly isolated from sputum （about 70.5% ）.The sensitive rates of PAE to gatifloxacin,ceftazidime,piperacillin/ Tazobactam were 100% ,83.2% （obvious decrease） ,80.8% （obvious decrease）,to cefotaxime,ceftriaxone were about 7.4% （on the rise）and 7.2% （on the rise）,and to the other 9 kinds were between 56.2% and 74.7% （obvious decrease ） .The sensitive rate of PAE in blood to the other 13 antibacterials except PiperacillinrFazobactam was obviously lower than that in sputum.Conclusion The resistance of PAE is serious,and Cardiovascular Medicine should monitor its drug-resistance.