下呼吸道感染的铜绿假单胞菌耐药性与基因型分析

目的了解我院2002年2月～2004年3月从肺炎患者痰标本中分离出来的90株铜绿假单胞菌的流行病学特征及耐药性,监测其流行趋势,给临床用药提供依据.方法对90株PA进行药敏试验,并采用优化反应体系的随机多态DNA分型 (RAPD)法进行流行病原学研究.结果 90株PA菌株被基因分型分为41型;抗生素分型分为24型;医院感染菌株对12种抗生素的耐药率明显高于社区感染菌株.结论基因分型法显示ICU病房有多重耐药菌株PA株爆发流行现象;社区感染患者用阿米卡星或哌拉西林治疗,医院感染患者可用亚安培南或头孢他啶加阿米卡星联合治疗;加强细菌实验室的监测工作,严格病区的消毒制度,是降低PA医院感染的有力措施.

Drug resistance and genotyping of pseudomonas aeruginosa in lower respiratory tract infection

Objective To study the 90 strains pseudomonas aeruginosa isolated from sputum of the pneumonia patient in our hospital from February 2002 to March 2004,to know their molecular epidemiology and drug resistance,monitoring their epidemic tendency,providing foundation for clinical medication.Methods Drug resistance in 90 strains PA and optimal reaction system of RAPD was used to study their molecular epidemiology.Results 90 strains PA were divided into 41 types by genotype;24 types by resistance;the drug resistance rate of hospital infection strains was higher than community infection strains.Conclusion Genotyping proved that outbreak of multidrug resistance strains PA in ICU,patients of hospital infection were cured by amikacin or cefoperazone; patients of community infection were cured by imipenem or ceftazidime united by amikacin.strengthening the surreillance of microbe laboratory,stricting disinfection institution of wards,it was the crucial measures to depress the hospital infection of PA.