动态分析铜绿假单胞茵实验及临床联合用药的耐药性

目的探讨铜绿假单胞菌实验及临床联合用药的耐药性，指导临床合理应用抗生素。方法用法国生物梅里埃全自动微生物鉴定／药敏VITEK32系统对铜绿假单胞菌的实验资料进行分析，并通过调查与实验菌株相对应的临床联合用药病案资料．统计分析其临床联合用药的耐药性。结果多重耐药性铜绿假单胞菌分离率逐年上升，其耐药率也逐年上升。对6种主要抗菌药的耐药率增加20％以上。从2004年1月开始出现全耐药株，至2005年6月该院已出现全耐药铜绿假单胞菌18株。其MIC值均有明显增加。临床联合用药方案中，以舒巴坦／丁胺卡那，舒巴坦／环丙沙星，他唑巴坦／丁胺卡那，亚胺培南／丁胺卡那耐药率较低。结论铜绿假单胞菌多重耐药情况十分严重。临床要根据药敏试验的MIC结果选择联合用药。

Dynamic analysis of drug resistance of Pseudomonas aeruginosa in laboratory and clinical twodrug regimen

Objective To analyze drug resistance status ofPseudomonas aeruginosa in the two-drug regimens in laboratory and clinical settings for more appropriate application of antibiotics. Methods The laboratory data of drug resistance rate of Pseudomonas aeruginosa identified with Biomerieux Vitek 32 system were collected. The clinical two-drug regimen data corresponding to anti-microbial sensitivity test were investigated, and the resistance rate of the clinical two-drug regimen was analyzed statistically. Results The isolation rate ofPseudomonas aeruginosa with multi-drug resistance increased steadily in recent years, and the resistance rate to 6 widely used antibiotics increased by over 20%. Two Pseudomonas aeruginosa strains resistant to all the 6 drugs were identified in January 2004, and till June 2005, totally 18 panresistant strains had been isolated with dramatic increases in MIC value. In the clinical two-drug regimen, sulbactam/amikacin, sulbactam/ciprofloxacin, tazobactam / amikacin, and imipenem / amikacin still had low resistant rates. Conclusions Multi-drug resistance of Pseudomonas aeruginosa to the antibiotics is a serious problem. A two-drug regimen based on anti-microbial susceptibility test should be chosen.