ICU与非ICU感染铜绿假单胞菌的分布及耐药性对比分析

目的对比重症监护病房（ICU）与非ICU感染铜绿假单胞菌的临床分布状况，分析比较两个病区的细菌耐药情况，为临床合理选用抗菌药物和控制院内感染提供依据。方法采用法国梅里埃公司生产的ATB-expmssion细菌鉴定仪对细菌进行鉴定，K-B纸片扩散法进行药敏试验，用WHONTE5．4软件分析病原菌的分离率及耐药率。结果美罗培南在ICU的耐药率（61．3％）显著高于非ICU的耐药率（27．0%）（P〈0．01），庆大霉素、头胞他啶、丁胺卡钠、氨曲南、哌拉西林、哌拉西林／它唑巴坦、替卡西林／克拉维酸、头孢曲松、头孢噻肟在ICU的耐药率显著高于非ICU的耐药率（P〈0．01），头孢吡肟在ICU的耐药率高于非ICU的耐药率（P〈0．05），ICU与非ICU对抗菌药物的耐药率差异有统计学意义（P〈0．05）。结论ICU铜绿假单胞菌的耐药率显著高于非ICU的耐药率，尤其是碳青酶烯类抗菌药物，应引起临床高度重视。

Infectious Distribution of P.aeruginosa in ICU and Non-ICU and Comparative Analysis of Drug Resistance

Objective To learn and compare the clinical infectious distribution and the drug resistance of Pseudomonas aeruginosa in ICU and non-ICU in order to provide the basis for rational administration of clinical antibacterial drug and nosocomial infection.Methods Identification of bacteria were performed by ATB-expression system and antibiotic sensitivity test adopted Kirby-bauer method. Data of isolation rate and drug resistant rates of bacteria were analyzed by WHONETS. 4 software. Remits The resistant rates of P. aeruginosa to meropenem were 61.3 % in ICU, higher than that of in non-ICU（27.0% ）（ P 〈 0.01 ）, the resistant rates of P. aeruginosa isolated from ICU to gentamicin, ceftazidime, amikacin, aztreonam, pipemcillin, piperaeillin/tazobactam, ficarcillin/clauvlanicacid, cedtriaxone and cefotaxime were higher than that of from non-ICU（ P 〈 0.01 ）, the resistant rates of cefepime from ICU is higher than from non-ICU（ P 〈 0.05）. There was significant difference between the resistant rates of ICU and non-ICU to antimierobial drugs（ P 〈0.05）. Conclusion The drug resistance of Pseudomonas aeruginosa isolated from ICU was higher significantly than from non-ICU, especially to carbapenms, so close attention should be taken by clinical doctors.