广州地区耐亚胺培南铜绿假单胞菌的感染现状及耐药性检测

目的调查广州地区耐亚胺培南铜绿假单胞菌在医院内的感染现状及耐药谱特性，帮助临床合理选用抗生素。方法用VITEK-32型全自动细菌分析系统筛选广东省中医院、南方医院、广州中医药大学附属第一医院、中山大学附属第二医院2005-2007年期间耐亚胺培南铜绿假单胞菌，并用琼脂稀释法检测其对亚胺培南的最低抑菌浓度。结果440株铜绿假单胞菌中，耐亚胺培南81株（18．41％）。在所测试的抗生素中，耐亚胺培南菌株组与非耐亚胺培南菌株组之间的耐药率差异明显，尤以庆大霉素（分别为65．43％、10．86％）、头孢他啶（分别为53．09％、10．03％）和阿米卡星（分别为53．09％、12．26％）显著。结论耐亚胺培南铜绿假单胞菌对多种抗生素耐药，且耐药率有逐年增高的趋势，在治疗时应根据药敏试验结果合理谨慎选用抗生素，有效控制及减缓耐药株的产生。

Imipenem resistance among Pseudomonas aeruginosa isolates: antimicrobial susceptibility analysis and epidemiology in Gnangzhou area

Objective To investigate the infection status and antimicrobial susceptibility of imipenem-resistant Pseudomonas aeruginosa to instruct clinical application of antibiotics. Methods Imipenem-resistant Pseudomonas aeruginosa strains isolated from Guangdong Provincial Hospital of Traditional Chinese Medicine,the first Affiliated Hospital of Guangzhou University of Chinese Medicine, Southern Hospital and the Second Affiliated Hospital of Sen Yat-sen University from 2005 to 2007 were collected and identified by VITEK-32 system. The minimal inhibitory concentrations (MIC) of them to 9 antibiotics, including imipenem, meropenem, cefotaxime, cefepime, gentamycin, amikacin, aztreonam, ciprofloxaein, and levofloxacin were detected by applying agar dilution method. Results A total of 440 strains of imipenem-resistant Pseudomonas aeruginosa were obtained from 4 major hospitals in Guangzhou province, in which 81 isolates were resistant to imipenem (18.41%). There was significant difference of drug resistance rate between imipenem resistance group and imipenem non-resistance group, especially to gentamicin (65.43% vs 10.86%), ceftazidime (53.09% vs 10.03%) and amikacin (53.09% vs 12.26%).Conelusion Imipenem resistant Pseudomonas aeruginosas are resistant to many kinds of antimierobial agents, and their resistant rate is increased year by year, in order to control and slow down the occurrence of the persisters, it should be paid more attention to choose antimicrobial agents rationally according to antimicrobial susceptibility test results and individual conditions of patients.