| 老年患者下呼吸道铜绿假单胞菌感染临床分布与耐药性分析 |
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| 引用本文： | 周毓,彭军,卢健聪,钟浩海.老年患者下呼吸道铜绿假单胞菌感染临床分布与耐药性分析[J].现代临床医学,2014,40(2):138-141. |
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| 作者姓名： | 周毓 彭军 卢健聪 钟浩海 |
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| 作者单位： | 广东省惠州市中心人民医院,广东省惠州市中心人民医院,广东省惠州市中心人民医院 呼吸科 惠州 516001,广东省惠州市中心人民医院 |
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| 摘 要： | 目的:分析老年患者下呼吸道铜绿假单胞菌感染临床分布与耐药性。方法:搜集2011年6月至2013年6月我院老年下呼吸道感染住院患者,分离培养出铜绿假单胞菌菌株痰标本156份,用VITEK2-Compact全自动细菌鉴定及药敏分析系统对临床标本中分离的156株铜绿假单胞菌进行鉴定,并采用琼脂扩散法进行体外药敏试验,依据美国临床实验室标准化协会(CLSI)最新折点判读结果。结果:非多重耐药(MDR)铜绿假单胞菌临床分离株对头孢噻肟、磺胺甲噁唑/甲氧苄啶耐药性最高,耐药率达70%以上;对亚胺培南、美罗培南、氨曲南和头孢哌酮/舒巴坦、头孢他啶、哌拉西林/舒巴坦、阿米卡星的耐药率均在20%以内,其中亚胺培南、美罗培南敏感性均达到100%。而MDR菌株对哌拉西林、头孢噻肟、庆大霉素、环丙沙星、妥布霉素、磺胺甲噁唑/甲氧苄啶高度耐药,耐药率达100%,对哌拉西林/他唑巴坦、头孢吡肟、阿米卡星耐药率高达60%以上,对亚胺培南、美罗培南、氨曲南依旧敏感性较好,耐药率均低于20%。结论:亚胺培南、美罗培南对铜绿假单胞菌有较好的敏感性,可作为老年患者重症下呼吸道铜绿假单胞菌感染治疗的首选药物,如MDR铜绿假单胞菌感染,可联合用药。在联合用药的同时应当加强医院的抗生素合理使用,规范临床用药。
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| 关 键 词： | 下呼吸道感染 铜绿假单胞菌 耐药性 |
| 收稿时间： | 2013/9/29 0:00:00 |
| 修稿时间： | 2013/9/29 0:00:00 |
Analysis of Clinical Distribution and Drug Resistance of Pseudomonas Aeruginosa in Patients with Lower Respiratory Tract Infection |
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| ZHOU Yu,PENG Jun,LU Jianchong and ZHONG Haohai.Analysis of Clinical Distribution and Drug Resistance of Pseudomonas Aeruginosa in Patients with Lower Respiratory Tract Infection[J].Journal of Modern Clinical Medicine,2014,40(2):138-141. |
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| Authors: | ZHOU Yu PENG Jun LU Jianchong and ZHONG Haohai |
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| Affiliation: | Zhou Yu;Peng Jun;Lu Jianchong;Zhong Haohai;Huizhou Center People’s Hospital; |
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| Abstract: | Objective To study the clinical distribution and drug resistance in patients with lower respiratory tract infection caused by Pseudomonas aeruginosa. Methods from 2011 June to 2013 June hospitalized patients in our hospital in elderly patients with lower respiratory tract infection, isolated and cultured from sputum specimens of Pseudomonas aeruginosa strain 156, system for the identification of 156 strains of Pseudomonas aeruginosa isolated from clinical specimens by VITEK2-Compact automatic bacteria identification and drug sensitivity analysis, and the drug sensitivity test in vitro agar diffusion method, according to CLSI latest break point interpretation results. Results Non MDR clinical isolates of Pseudomonas aeruginosa to cefotaxime, sulfamethoxazole / trimethoprim resistance, resistance rate of more than 70%; to imipenem, meropenem, aztreonam and Cefoperazone / Shubatan, ceftazidime, piperacillin / sulbactam, Amikacin resistance rates are within 20%, the imipenem, meropenem sensitivity reached 100%. While the MDR strain to piperacillin, cefotaxime, ciprofloxacin, gentamicin, tobramycin, sulfamethoxazole / trimethoprim highly resistant, resistant rate was 100%, of piperacillin / tazobactam, cefepime, Amikacin resistance as high as 60%, to imipenem, meropenem, aztreonam is still good sensitivity, drug resistance is lower than 20%. Conclusion Imipenem, meropenem has better sensitivity of Pseudomonas aeruginosa, the drug of choice in patients with severe lower respiratory tract infection with Pseudomonas aeruginosa treatment, such as MDR of Pseudomonas aeruginosa infection, can be combined with medication. We should strengthen the rational use of antibiotics in hospital, standardize clinical drug. |
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| Keywords: | lower respiratory tract infection Pseudomonas aeruginosa resistance |
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