铜绿假单胞菌耐药性及抗生素压力下药敏监测分析

Analysis of drug-resistance of Pseudomonas aeruginosa and drug susceptibility under antibiotic pressure

目的通过观察铜绿假单胞菌耐药性及在抗生素压力下各药物耐药动态改变,了解其耐药特点,指导临床合理用药。方法回顾分析2014年1月-6月某三甲医院520例铜绿假单胞菌药敏结果,并对其中同一患者不同时间段检测的具有2次药敏结果的50例铜绿假单胞菌药敏结果进行统计分析。结果铜绿假单胞菌具有较强的耐药性,对头孢噻肟、氯霉素、米诺环素耐药率均>80.0%,对头孢哌酮/舒巴坦、阿米卡星、庆大霉素、头孢吡肟、头孢他啶的耐药率<25.0%,可作为治疗铜绿假单胞菌的经验用药。50例铜绿假单胞菌在抗生素使用后各药物耐药率除头孢哌酮/舒巴坦、米诺环素耐药率未发生变化,其余各药物均呈上升趋势。结论铜绿假单胞菌具有较强的耐药性,治疗过程中容易获得耐药变异,有必要实施持续性监控,获得可靠的药敏结果。

Objective To guide rational medication in clinical by observing the drug resistance of Pseudomonas aeruginosa and its dynamic changes to each drug under antibiotic pressure and by understanding the resistant characteristics of Pseudomonas aeruginosa. Methods A retrospective analysis was carried out on 520 cases of drug susceptibility results of Pseudomonas aeruginosa i.n a Grade - A First - class hospital during January - June in 2014, and statistical analysis was carried out on 50 cases of patients who had twice drug susceptibility test of Pseudomonas aeruginosa at different time periods. Results Pseudomonas aeruginosa had stronger resistance to cefotaxime, chloramphenicol and minocycline（ resistant rates 〉 80% ）, but lower resistance to cefoperazone/sulbactam, amikacin, gentamicin, cefepime and ceftazidime（ resistant rates 〈 25% ） , which were empirical drugs for the treatment of Pseudomonas aeruginosa. After application of antibiotics, except for cefoperazone/sulbactam and minocycline, to which drug resistant rate of Pseudomonas aeruginosa had no changes, the resistant rates to other drugs were all increasing. Conclusion Pseudomonas aeruginosa has strong resistance, which is prone to drug resistance mutation during the treatment. Therefore, continuous monitoring is necessary for reliable drug susceptibility results.