老年下呼吸道感染患者铜绿假单胞菌耐药性分析

Analysis of drug resistance of Pseudomonas aeruginosa in elderly patients with lower respiratory tract infection

目的探讨老年下呼吸道感染患者铜绿假单胞菌对常用抗菌药物的耐药性。方法选取2018年2月至2019年5月本院所收治老年下呼吸道感染患者110例,进行痰标本细菌培养,对其中铜绿假单胞菌进行体外药敏试验,并对试验结果进行分析。结果110例老年下呼吸道感染患者中共计分离得到铜绿假单胞菌60株,检出率为54.6%;60株铜绿假单胞菌对庆大霉素的耐药率高达63.3%,其次为妥布霉素、哌拉西林、环丙沙星等;对氨曲南的耐药率最低,仅为13.3%;15例β-内酰胺酶阳性铜绿假单胞菌体外药敏试验结果显示,其对于庆大霉素、妥布霉素、哌拉西林、环丙沙星、哌拉西林/他唑巴坦的耐药率均为100.0%,其次为头孢吡肟、阿米卡星、头孢哌酮,以氨曲南最低,耐药率仅为20.0%。结论铜绿假单胞菌对于庆大霉素、哌拉西林、头孢哌酮等常用抗生素均具有较高的耐药性,但其中氨曲南对此类致病菌仍可表现出明显的抗菌活性,可作为替代药物用于铜绿假单胞菌感染所致的老年下呼吸道感染患者的临床治疗。

Objective To investigate the drug resistance of Pseudomonas aeruginosa to common antibiotics in elderly patients with lower respiratory tract infection.Methods 110 patients with lower respiratory tract infection in our hospital were enrolled in this study from February 2018 to May 2019.The sputum specimens were cultured in vitro,and Pseudomonas aeruginosa was tested for in-vitro susceptibility.The results of drug susceptibility test were analyzed.Results A total of 60 strains of Pseudomonas aeruginosa were isolated from the 110 elderly patients,with a detection rate of 54.6%.The resistance rate of 60 strains of Pseudomonas aeruginosa to gentamicin was as high as 63.3%,followed by tobramycin(46.7%),piperacillin(41.7%),ciprofloxacin(38.3%),etc.The resistance rate to aztreonam was the lowest(13.3%).The in-vitro susceptibility test was conducted in only 15 patients infected withβ-lactamase-producing Pseudomonas aeruginosa.And this test results showed that the drug resistance rates to gentamicin,tobramycin,piperacillin,ciprofloxacin,piperacillin/tazobactam were 100.0%,followed by cefepime,amikacin and cefoperazone,and the resistance rate to aztreonam was the lowest,only 20.0%.Conclusions Pseudomonas aeruginosa reveals a high resistance to common antibiotics such as gentamicin,piperacillin and cefoperazone.While aztreonam can still exhibit an obvious anti-bacterial activity against Pseudomonas aeruginosa.And it can be used as an alternative medicine in the clinical treatment of lower respiratory tract infection caused by Pseudomonas aeruginosa in elderly patients.