耐亚胺培南铜绿假单胞菌的检出率与耐药性分析

Prevalence and antimicrobial resistance of imipenem-resistant Pseudomonas aeruginosa

目的调查耐亚胺培南铜绿假单胞菌的检出率及耐药性,为临床治疗提供参考。方法收集医院2013年1月-2015年6月临床各种标本中分离的铜绿假单胞菌共1 250株,其中耐亚胺培南铜绿假单胞菌(IRPA)438株,菌种鉴定和药敏试验采用法国生物梅里埃公司VITEK-2Compact全自动微生物分析仪进行测定,采用K-B法测定头孢哌酮/舒巴坦的敏感性。结果在1 250株铜绿假单胞菌中438株对亚胺培南耐药,耐药率为35.0%;铜绿假单胞菌对亚胺培南的耐药率从2013年的32.6%升至2015年的41.0%;2013-2015年IRPA除对头孢哌酮/舒巴坦的耐药率保持稳定外,对其他常用抗菌药物的耐药率均呈逐年下降趋势,对阿米卡星耐药率从2013年的39.0%降至2015年的9.7%;2013-2015年共检出耐阿米卡星IRPA 109株,除对头孢吡肟的耐药率为78.9%外,对其他抗菌药物的耐药率均>85.0%。结论近年来医院分离的铜绿假单胞菌对亚胺培南耐药率呈上升趋势,但IRPA对常用抗菌药物的耐药率不升反降,特别是对阿米卡星的耐药率下降明显,耐阿米卡星IRPA对常用抗菌药物的耐药率高。

OBJECTIVE To investigate the detection rate of imipenem-resistant Pseudomonas aeruginosa and observe the drug resistance so as to provide guidance for clinical treatment.METHODS A total of 1 250 strains of P.aeruginosaisolated from various clinical specimens were collected from Jan 2013 to Jun 2015,including 438 strains of imipenem-resistant P.aeruginosa.The strains were identified by using VITEK-2Compact automatic microorganism analyzer of BioMérieux,France;the drug susceptibility testing was performed,and the drug susceptibility to cefoperazone-sulbactam was tested by using K-B method.RESULTS Of the 1 250 strains of P.aeruginosa,438 were resistant to imipenem,with the drug resistance rate of 35.0%.The drug resistance rate of the P.aeruginosa to imipenem increased from 32.6%in 2013 to 41.0%in 2015.The drug resistance rates of the imipenem-resistant P.aeruginosato all the commonly used antibiotics were decreased year by year from 2013 to 2015except that the drug resistance rate to cefoperazone-sulbactam remained stable;the drug resistance rate to amikacin dropped from39.0%in 2013 to 9.7% in 2015.Totally 109 strains of imipenem-resistant P.aeruginosathat were resistant to amikacin were isolated from 2013 to 2015;the drug resistance rate to all the antibiotics was more than 85.0% except that the drug resistance rate to cefepime was 78.9%.CONCLUSIONThe drug resistance rate of the clinical P.aeruginosaisolates to imipenem shows an upward trend in recent years,however,the drug resistance rate of the imipenem-resistant P.aeruginosato the commonly used antibiotics is decreased,the drug resistance rate to amikacin is remarkably decreased.The imipenem-resistant P.aeruginosastrains that are resistant to amikacin are highly resistant to the commonly used antibiotics.