多重耐药铜绿假单胞菌感染危险因素及防治策略

目的调查院内铜绿假单胞菌的耐药性,分析多重耐药铜绿假单胞菌（MDRP）院内感染的危险因素,为临床抗感染治疗提供依据。方法采用回顾性调查方法,对2006年1月至2008年12月分离的铜绿假单胞菌对临床常用抗菌药物的耐药性进行分析。结果3年间分别分离铜绿假单胞菌312株、343株和426株,铜绿假单胞菌对常用抗菌药物的耐药性有逐年上升趋势。2006年,铜绿假单胞菌对头孢哌酮/舒巴坦较敏感,耐药率为16.3%,2007年和2008年对美罗培南较敏感,耐药率分别为15.2%和19.9%。2006年分离MDRP 88株,占28.2%,2007年分离93株,占27.1%,2008年分离132株,占30.9%。3年间MDRP对头孢哌酮/舒巴坦较敏感,耐药率分别为26.1%,24.7%和28.8%。结论及时准确的细菌鉴定及药敏试验,能尽早发现MDRP及感染情况,一旦发现可疑病例即实施隔离,强化手卫生是预防和控制MDRP医院感染的重要措施。

Risk factors for nosocomial infections caused by multidrug resistant Pseudomonas aeruginosa and the preventive strategies

Objective To evaluate the drug resistance of Pseudomonas aeruginosa,and to analyze the risk factors for multidrug resistant Pseudomonas aeruginosa（MDRP） infection.Methods The multidrug resistance of Pseudomonas aeruginosa isolated during January 2006 and December 2008 was analyzed with retrospective study.Results There were respectively 312,343 and 426 stains of Pseudomonas aeruginosa isolated from 2006 to 2008,showing an increasing trend.The isolated stains of Pseudomonas aeruginosa were sensitive to cefoperazone/sulbactam in 2006（drug resistance rate,16.3%）,meropenem in 2007 and 2008（drug resistance rate,15.2% and 19.9%,respectively）.Eighty-eight MDRP strains（88/312,28.2%）were isolated in 2006,93（93/343,27.1%） in 2007,and 132（132/426,30.9%） in 2008.The MDRP strains were sensitive to cefoperazone/sulbactam in all the three years,with drug resistance rates of 26.1%,24.7% and 28.8% respectively in 2006-2008.Conclusion Timely identification of bacteria and drug susceptibility tests contribute to the finding of MDRP infection.The suspected patients with MDRP infection should be isolated.Strengthening of hand hygiene is an important measure for prevention and control of nosocomial MDRP infection.