289株铜绿假单胞菌医院感染现状及体外耐药监测

目的：研究铜绿假单胞菌医院感染现状、分布特征，并分析其耐药谱及多重耐药性，指导临床合理用药。方法：用VITEK32型全自动细菌鉴定分析系统对临床标本中分离的289株铜绿假单胞菌进行鉴定，并采用Kitty—Bauer法选用22种抗菌药物进行药物敏感试验。结果:289株铜绿假单胞菌主要来源于痰标本，占77．2％，其次为分泌物和尿液；其在临床病区分布中居前3位者依次为呼吸内科、神经外科、老年病科。289株铜绿假单胞菌对环丙沙星、阿米卡星、亚胺培南、头孢吡肟、头孢他啶和哌拉西林／他唑巴坦的耐药率较低，均小于40％；而对氯霉素、复方新诺明、氨苄西林、头孢噻吩、萘啶酸、阿莫西林／克拉维酸和头孢西丁则表现出高度耐药；且铜绿假单胞菌多重耐药率呈上升趋势。结论:铜绿假单胞菌临床分离株耐药现状严重，应合理选择和使用抗菌药物，以减少耐药株的出现与扩散。

Nosocomial infection status and antimicrobial resistance surveillance among 289 clinical isolates pseudomonas aeruginosa

Objective To investigate the distribution and multi-drug resistance of P.aeruginosa in Renming hospital of Wuhan university.Methods VITEK32 was used for the identification of 289 P.aeruginosa clinical isolates and the resistance was determined by Kirty-Bauer method.Results Most of 289 strains were isolated from sputum (77.2%),secretion (8.0%)and urine (3.1%).289 strains were mainly isolated from department of respiratory diseases(26.6%),department of nuerosurgery (25.3%) and geriatrics department (16.3%).Result of susceptibility test showed that the resistance rates of ciprofloxacin,amicaxin,imipenem,cefepime,ceftazidime and piperacillin-tazobactam was respectively below 40%.P.aeruginosa was highly resistant to chloramphenicol,SMZ,ampicillin,cephalothin,nalidixic acid,amoxillin-clavulanic acid and cefoxitin.The trend of multidrug resistance of P.aeruginosa is increasing.Conclusion The resistance status of P.aeruginosa is very serious.And in order to reduce or prevent the occurrence of resitant isolate,we should rationally choose and use antibiotics according to the susceptibility test result.