2007-2009年医院感染铜绿假单胞菌的耐药性分析

目的 了解医院铜绿假单胞菌对临床常用抗菌药物的耐药率,为临床经验性治疗及控制医院感染提供依据.方法 对2007-2009年1694株铜绿假单胞菌感染病例及耐药率进行回顾性调查与统计,采用常规方法对临床送检的标本进行细菌分离、培养、鉴定及药敏试验.结果 铜绿假单胞菌主要来源于痰液,占68.0％;3年间对16种抗菌药物耐药水平差异均有统计学意义(P＜0.05); 1694株铜绿假单胞菌对16种抗菌药物总耐药率为:环丙沙星26.9％、头孢哌酮/舒巴坦33.0％、美罗培南33.5％、头孢他啶33.7％、亚胺培南/西司他丁39.6％、氨曲南39.2％、头孢吡肟42.0％、左氧氟沙星42.8％、阿米卡星46.4％、哌拉西林/他唑巴坦48.4％、头孢哌酮50.7％、哌拉西林56.2％、庆大霉素59.8％、头孢曲松64.1％、替卡西林/克拉维酸64.6％、头孢噻肟69.3％.结论 铜绿假单胞菌对临床常用抗菌药物耐药现象严重,仅环丙沙星、头孢哌酮/舒巴坦、美罗培南、头孢他啶、氨曲南、亚胺培南/西司他丁保持相对高的抗菌活性.

Antibiotic resistance of Pseudomonas aeruginosa causing nosocomial infection from 2007 to 2009

OBJECTIVE To investigate the drug resistance of Pseudomonas aeruginosa to common antibiotics,so as to provide basis for empirical treatments and antibiotics use.METHODS The clinical data of patients had infection of P.aeruginosa(totally 1694 strains) from 2007 to 2009 were retrospectively analyzed,the bacterial isolation,culture,identification,and drug susceptibility test were performed for the clinically submitted specimens by routine method,and the statistical analysis of drug resistance was performed.RESULTS The P.aeruginosa isolates were mainly isolated from sputum(68.0%);the difference in drug resistance to 16 antibiotics during three years was statistically significant(P<0.05);the overall resistance rates of all 1694 P.aeruginosa to 16 kinds of antibiotics were as the following:ciprofloxacin 26.9%,cefoperazone/sulbactam 33.0% meropenem 33.5%,ceftazidime 33.7%,imipenem/cilastatin 39.6%,aztreonam 39.2%,cefepime 42.0%,levofloxacin 42.8%,amikacin 46.4%,piperacillin/tazobactam 48.4%,cefoperazone 50.7%,piperacillin 56.2%,gentamicin 59.8%,ceftriaxone 64.1%,ticarcillin/clavulanic acid 64.6%,and cefotaxime 69.3%.CONCLUSION Our results indicate that P.aeruginosa is highly resistant to common antibiotics,ciprofloxacin,cefoperazone/sulbactam,meropenem,ceftazidime aztreonam and imipenem/cilastatin keep high antibacterial activity against P.aeruginosa.