177株医院感染铜绿假单胞菌的耐药特性探讨

目的 探讨医院感染铜绿假单胞菌(PAE)的标本分布和耐药性,为临床医师合理用药提供实验室依据.方法 细菌培养和鉴定严格按照《全国临床检验操作规程》进行；药敏试验采用K-B法进行.结果 177株铜绿假单胞菌以呼吸道标本中检出率最高占55.4％;其次为脓液标本占13.0％;尿液标本第3位,占12.4％；PAE对亚胺培南、美罗培南、头孢哌酮/舒巴坦耐药率最低为5.6％～6.2％:对磺胺甲噁唑/甲氧苄啶耐药率最高为55.4％；对其他常用抗菌药物均产生不同程度的耐药；临床标本中未发现铜绿假单胞菌泛耐药株.结论 基层医院PAE的耐药率明显低于城市大型综合医院,但医院PAE耐药性已比较严重,有关管理部门应采取有效措施,遏制PAE耐药性快速增长的不良趋势.

Discussion of antimicrobial resistance of 177 isolates of Pseudomonas aeruginosacausing nosocomial infections

OBJECTIVE To investigate the specimen sources and antimicrobial resistance of Pseudomonas aeruginosa causing nosocomial infections and provide the experimental evidence for clinically reasonable use of the antibiotics.METHODS Referring to National Guide to Clinical Laboratory Procedures,the strains were cultured and identified;the drug susceptibility testing was performed by K-B methods.RESULTS The isolation rate of P.aeruginosa from respiratory tract(55.4%) was the highest,followed by the pus specimens(13.0%) and the urine specimens(12.4%);the resistance rates of P.aeruginosa to imipenem,meropenem,cefoperazone/sulbactum were the lowest,varying from 5.6% to 6.2%;the resistance rate to trimethoprim/sulfamethoxazole was the highest(55.4%);P.aeruginosa was resistant to the other commonly used antibiotics in varying degrees;no strains of pandrug-resistant P.aeruginosa was isolated from the clinical specimens.CONCLUSION The resistance rate of P.aeruginosa in grass-root hospital is distinctly lower than that in large scale general hospital in the city;the drug resistance of P.aeruginosa has been serious,so the management departments should adopt the effective measures to restrain rapidly increasing tendency of drug resistance of P.aeruginosa.