2010~2013年铜绿假单胞菌对抗菌药物的耐药性分析

Analysis of antibacterial resistance of Pseudomonas aeruginosa during 2010-2013

目的分析铜绿假单胞菌(PA)的临床分布特征与耐药性,以指导临床医师合理使用抗菌药物。方法回顾性分析2010年1月至2013年12月红桥医院临床分离的PA菌株的药敏试验结果和标本分布情况,应用WHONET5.5软件进行数据统计分析。结果共分离出752株PA,标本来源以痰液为主(占86.8%),其次是伤口分泌物(占5.7%)。药敏结果显示PA对亚胺培南、美罗培南、头孢哌酮/舒巴坦的敏感性最高,耐药率分别为1.6%、2.9%、1.9%;其次为环丙沙星、左氧氟沙星、阿米卡星、庆大霉素、妥布霉素、头孢吡肟、哌拉西林/他唑巴坦,耐药率分别为11.3%、12.5%、14.0%、16.5%、15.0%、11.6%、14.1%;对其他抗菌药物的耐药率均大于20.0%;对甲氧苄定/磺胺甲噁唑的耐药率最高,达81.4%。结论 PA主要引起呼吸道感染,对常用抗菌药物的耐药率相对较低。临床医师应合理使用抗菌药物,以减少耐药菌株的产生。

Objective To analyze the clinical distribution and antimicrobial resistance of Pseudomonas aeruginosa （PA） so as to guide the reasonable clinical use of antibiotics .Methods The results of drug susceptibility testing of PA strains isolated from pa‐tients in the Hongqiao Hospital from Jan .2010 to Dec .2013 and distribution of specimens were retrospectively analyzed .The WHO‐NET5 .5 software was used for data statistic analysis .Results A total of 752 PA strains were isolated and were most isolated from sputum（accounted for 86 .8% ） ,followed with secretions（accounted for 5 .7% ） .The drug resistance rates of PA to imipenem ,mero‐penem and cefoperazone‐sulbactam were 1 .6% ,2 .9% and 1 .9% ,respectively ;while the drug resistance rates to ciprofloxacin ,levo‐floxacin ,amikacin ,gentamicin ,tobramycin ,cefepime and piperacillin‐tazobactam were 11 .3% ,12 .5% ,14 .0% ,16 .5% ,15 .0% , 11 .6% and 14 .1% ,respectively ;the drug resistance rates to other antibiotics were higher than 20 .0% .The drug resistance rate to sulfamethoxazole‐trimethoprim was the highest（81 .4% ） .Conclusion PA may mainly induce respiratory tract infections ,and the drug resistance rates of PA to the commonly used antibiotics are relatively low .The clinicians should reasonably use antibiotics so as to reduce the resistant strains .