2007-2010年铜绿假单胞菌临床分布特征与耐药性分析

目的 了解湖州市中心医院铜绿假单胞菌临床分布特征与耐药性.方法 采用常规方法分离,用VITEK-2 Compact全自动微生物分析仪进行菌种鉴定,用KB法进行药敏试验.结果 分离到铜绿假单胞菌2384株,主要来自ICU,其次呼吸科；大部分来自痰液标本,占84.0％；分离出耐亚胺培南铜绿假单胞菌(IRPA) 1082株,分离率为45.4％,2007-2010年IRPA的分离率依次为44.1％、55.9％、46.8％、31.3％；对14种抗菌药物全耐药菌株89株,分离率为3.7％；IRPA对妥布霉素、环丙沙星、左氧氟沙星、哌拉西林、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢他啶、头孢吡肟、氨曲南、磺胺甲噁唑/甲氧苄啶、米诺环素耐药率均＞50.0％,仅对阿米卡星耐药率＜30.0％.结论 铜绿假单胞菌出现多药耐药,甚至出现全耐药菌株,临床治疗非常困难；应合理、规范使用抗菌药物并加强对耐亚胺培南铜绿假单胞菌的耐药性监测与医院感染的综合管理.

Clinical distribution of Pseudomonas aeruginosaand analysis of drug resistance

OBJECTIVE To investigate the characteristics of distribution and drug resistance of Pseudomonas aeruginosa isolated from clinical specimens in Huzhou Central Hospital.METHODS By means of the conventional isolation method,VITEK-2 Compact automatic microorganism analyzer was adopted for bacteria identification,and the drug susceptibility testing was performed with K-B method.RESULTS There were 2384 strains of P.aeruginosa isolated which were mainly isolated from ICU,followed by respiratory department;most of the isolates were from sputum specimens,accounting for 84.0%;totally 1082 strains of imipenem-resistant P.aeruginosa were isolated with the isolation rate of 45.4%,the isolation rates of IRPA during 2007-2010 were 44.1%,55.9%,46.8%,and 31.3%,respectively;totally 89 strains detected were resistant to 14 antibiotics with the isolation rate of 3.7%;the resistance rates of IRPA to tobramycin,ciprofloxacin,lefofloxacin,piperacillin/tazobactam,cefoperazone/sulbactam,ceftazidime,cefepime,aztreonam,sulfamethoxazole,and minocycline were higher than 50.0% except less than 30.0% to amikacin.CONCLUSION Multidrug-resistance,even the whole-drug resistance,has been occurred in P.aeruginosa,which results in the difficulty for clinical treatment;it is necessary to use antibiotics reasonably and strengthen the surveillance for drug resistance of IRPA and comprehensive management of nosocomial infections.