111株铜绿假单胞菌感染的分布及药敏分析

目的了解铜绿假单胞菌对抗菌药物敏感及耐药情况，从而指导临床合理用药。方法对南宁市第七人民医院各种临床标本中所分离的铜绿假单胞菌药敏结果进行回顾性分析。结果共分离铜绿假单胞菌111株，其中呼吸道（痰及咽拭子）分离出80株（72．0％）；伤口分泌物（脓及分泌物）分离出25株（22．5％）。铜绿假单胞菌对亚胺培南、美罗培南、头孢哌酮／舒巴坦、阿米卡星的耐药率分别为6．3％、9．9％、10．8％、18．0％；对复方新诺明、氨苄西林的耐药率高达97．3％及91．9％。结论铜绿假单胞菌主要以呼吸道及伤口感染为主，其对抗菌药物耐药情况严重。严格执行抗菌药物的管理制度，使临床用药在药敏试验结果指导下进行，对控制铜绿假单胞菌耐药率具有重要意义。碳青霉烯类抗菌药物（亚胺培南、美罗培南）可作为南宁市第七人民医院铜绿假单胞菌重症感染的首选药物；头孢哌酮／舒巴坦、阿米卡星可作为次选药物。

Distribution and drug resistance of 111 strains of Pseudomonas aeruginosa

Objective To study the sensitivity and drug tolerance of Pseudomonas aeruginosa to antibiotics,so as to guide the rational use of antibiotics in clinic. Methods A retrospective analysis was made for the results of drug sensitivity tests of Pseudomonas aeruginosa isolated from clinical samples in our hospital. Results 111 strains of Pseudomonas aerugin0sa were isolated in total,in which 80 strains from respiratory tracts （72.0%） and 25 strains from wound secretion （22.5 %）. Its drug tolerance rates to imipenem and meropenem, cefoperazone/sulbactam and amikacin sulfate were 6.3% and 9.9% ,10.8% and 18.0% respectively; and its drug tolerance rate to compound sulfamethoxazole and ampicillin was 97.3% and 91.9% respectively. Conclusion The infection of Pseudomonas aeruginosa is found mainly in respiratory tract and infected wound,and it has a strong drug tolerance to antibiotics. The management of antibiotic application should be strict and clinical application of antibiotics should be performed under the guidance with the drug sensitivity test results. Carbapenem antibiotics like imipenem and meropenem may be the first-choice for severe infection of Pseudomonas aeruginosa. Cefoperazone/sulbactam and amikacin may be the second- ehoiced drugs.