不同年代老年气管切开患者铜绿假单胞菌对抗生素耐药性分析

目的 比较不同年代气管切开患者铜绿假单胞菌对抗生素耐药。方法 对1980-1990年23例气管切开患者痰培养101株铜绿假单胞菌耐药，1991-1995年26例气管切开患者痰培养74株铜绿假单胞菌耐药、1996-2000年41例气管切开患者痰，培养193株铜绿假单胞菌对抗生素耐药进行比较。结果 铜绿假单胞菌对氨曲南，头孢噻肟钠，环丙沙星，替卡西林（羧噻吩青霉素）耐药，1996-2000年与1991-1995年相比有显著意义；对哌拉西林（氧哌嗪青霉素），头孢哌酮钠耐药在1991-1995年曾一度下降，1996-2000年又开始增加；对庆大霉素耐药逐年增加；对阿米卡星（丁胺卡那霉素）耐药逐年下降；铜绿假单胞菌对头孢他啶及亚胺培南耐药多年来一直保持稳定；铜绿假单胞菌对氨苄西林，头孢唑林钠，头孢曲松钠，头孢呋辛钠，头孢呋新脂，头孢噻吩，呋喃坦啶。四环素，甲氧苄氨嘧啶耐药一直在85.71%-100%之间，结论 老年气管切开患者铜绿假单胞菌对大多数抗生素耐药有增加趋势，其中氨曲南，头孢噻肟钠，环丙沙星，替卡西林，庆大霉素，头孢哌酮钠，哌拉西林耐药明显增加，对头孢他啶，亚胺培南耐药多年保持稳定。

Drug Resistance of Pseudomonas aeruginosa in the Elder Patients with Tracheostomy in 1990s

OBJECTIVE To compare the drug resistance of Pseudomonas aeruginosa in the elder patients with tracheostomy in 1990s. METHODS One hundred and one strains (from 26 cases 1991 1995) and 193 strains (from 41 cases to each in 1996 2000) were tested drug sensitivity of P. aeruginosa and compared each to other. RESULTS Drug resistance of P. aeruginosa to aztreonam, cefotaxime, ciprofloxacin and ticarcillin was increasing significantly in 1996 2000 as compared with 1991 1995 period; to piperacillin and cefoperazone was descending temporarily in 1991 1995 and increasing in 1996 2000; to gentamicin was increasing every year and to amikacin was descending every year, to ceftazidime and imipenem was stable for recent decades and to ampicillin, ceftazolin, ceftriaxone, cefuroxime axetil, cefalotin, nitrofurantoin, tetracycline and trimethoprim was between 85.7% 100%. CONCLUSIONS Drug resistance of P. aeruginosa in the elder patients with tracheostomy was increasing from year to year, especially to aztreonam, cefotaxime, ciprofloxsacin, ticarcillin, gentamicin, cefoperazon and piperacillin biut ceftazidim and imipenem were stable for recent decades .