11年间烧伤病房铜绿假单胞菌耐药率调查

Investigation on the drug resistance of Pseudomonas aeruginosa in our burn ward in the past 11 years

目的 总结笔者单位烧伤病房近 11年来抗生素使用和铜绿假单胞菌耐药的情况变化 ,为今后合理使用抗生素提供参考。 方法 调查 1991～ 2 0 0 1年烧伤病房细菌的流行病学 ,从抗生素成人药物平均日剂量 (DDDs)和用药天数排序中了解铜绿假单胞菌的耐药变化。 结果 (1)病房菌以金黄色葡萄球菌 (10 .5 3%～ 34.4 0 % )和铜绿假单胞菌 (75 .6 6 %～ 11.4 7% )为主。 (2 )使用率较高的抗生素有青霉素、阿米卡星、万古霉素、亚胺培南 西司他丁钠盐和头孢他啶。 (3)铜绿假单胞菌对抗生素的耐药率逐渐上升 ,依次为 :哌拉西林 (41.5 7%～ 10 0 .0 0 % )、亚胺培南 西司他丁钠盐 (36 .36 %～98.4 6 % )、头孢他啶 (2 3.4 6 %～ 97.85 % )、阿米卡星 (13.16 %～ 10 0 .0 0 % )、环丙沙星 (6 .90 %～ 10 0 .0 0 % )。 结论 铜绿假单胞菌耐药性增加 ,主要与广泛应用抗生素有关。

Objective To analyze the use of antibiotics and the drug resistance of Pseudomonas aeruginosa in the burn ward of our hospital in the past 11 years, so as to optimize the use of antibiotics in the future. Methods Bacterial epidemiology during 1991~2001 in our burn ward was investigated. The change of the drug resistance of Pseudomonas aeruginosa was observed by defined daily dose (DDD) of antibiotics in adult patients and by the ranking of antibiotic administration days. Results (1)Staphylococcus aureus (10.53%~34.40%) and Pseudomonas aeruginosa (75.66%~11.47%) were dominant in our burn ward. (2)Predominant antibiotics used included Penicillin, Amikacin, Vancomycin, Imipenem and Ceftazidime.(3)There was increasing drug resistance of Pseudomonas aeruginosa to the following antibiotics ranking in following order:Piperacillin ( 41.57%~100.00%), Imipenem( 36.36%~98.46%), Ceftazidime (23.46%~97.85%), Amikacin(13.16%~100.00%) and ciprofloxacin (6.90%~100.00%).Conclusion There was increasing drug resistance of Pseudomonas aeruginosa to all antibiotics, which might be related to antibiotic abuse.