铜绿假单胞菌3029株分离情况和耐药性分析

SEPARATION AND DRUG RESISTANCE OF 3029 STRAINS OF PSEUDOMONAS AERUGINOSA

目的了解2007—2011年临床分离的3 029株铜绿假单胞菌的分离情况和耐药性,为临床提供用药的参考依据。方法按照操作规程将临床分离鉴定的铜绿假单胞菌进行药敏分析,并采用WHONET5.6软件进行统计分析。结果 1铜绿假单胞菌5年的分离率为15.45%;2在临床科室分布中铜绿假单胞菌在ICU的分离率最高为34.83%,其次为呼吸内科19.12%;3在标本分布中痰液和呼吸道分泌物中的分离率最高占67.98%,其次是脓液创口分泌物9.84%;4在19种常用抗菌药物中,耐药率大于90%的有6种:氨苄西林、氨苄西林/舒巴坦、呋喃妥因、复方新诺明、头孢曲松、头孢替坦;抗菌活性较好的有替考拉宁/克拉维酸、阿米卡星、庆大霉素、妥布霉素、哌拉西林/他唑巴坦、头孢吡肟、头孢他啶等,耐药率低于20%。结论铜绿假单胞菌的耐药机制复杂,耐药情况严重,临床治疗上要合理用药,注意监测其分布特点和耐药趋势,完善管理制度以减少医院感染。

Objective To investigate the distribution and drug resistance of 3029 strains of Pseudomonas Aeruginosa isolated from2007 to 2011,and to provide reference for clinical medicine.Methods Drug sensitivity of Pseudomonas Aeruginosa which separated and identified from clinical practice was tested by the operation procedure and analyzed by WHONET5.6.Results The total separation rate of Pseudomonas Aeruginosa in five years was 15.45%.In the clinical department distribution,the highest separation rate of Pseudomonas Aeruginosa was from ICU（34.83%）,and respiratory medicine followed（19.11%）.In the sample distribution,the highest separation rate of Pseudomonas Aeruginosa was from sputum and respiratory secretions（67.98%）,the pus and wound secretion followed（9.84%）.Between 19 kinds of antimicrobial drugs which are commonly used,there were 6 kinds of Ampicillin,Ampicillin/Sulbactam,Furantoin,Compound SMZ,Ceftriaxone and Cefotetan showed more than 90% drug resistance rate.Teicoplanin/Clavulanic acid,Amikacin,Gentamicin,Tobramicin,Piperacillin/Tazobactam,Cefepine,Ceftazidime had better activity than others,the resistance rate was less than 20%.Conclusion The resistance mechanism of Pseudomonas Aeruginosa is complex and serious.In clinical treatment,the rational use of medical drugs,monitor the distribution characteristics and drug resistance trend of Pseudomonas Aeruginosa must be paied great attention,consummate the management system are very important in order to reduce the hospital infection.