对碳青霉烯耐药与敏感的铜绿假单胞菌耐药谱比较分析

目的了解耐碳青霉烯铜绿假单胞菌的分布,比较铜绿假单胞菌对碳青霉烯耐药与敏感菌株的耐药谱特性,以指导临床合理使用抗生素。方法采用稀释法对在2004年1月至12月间从临床分离的铜绿假单胞菌进行12种常用抗生素敏感性测定,采用卡方检验比较碳青霉烯耐药组与敏感组铜绿假单胞菌耐药性的差别。结果91株铜绿假单胞菌中有28株对碳青霉烯耐药,主要来源于痰标本(88．3%)；分别来自神经外科、呼吸科重症监护病房(RICU)、重症监护病房(ICU)等病区。碳青霉烯耐药株对包括头孢吡肟、头孢他啶、氨曲南、环丙沙星在内的其余9种抗生素的耐药率均明显高于敏感株(P值均＜0．01)。结论对碳青霉烯耐药的铜绿假单胞菌对大多数常用抗生素呈更强的耐药性,且其多重耐药状况非常严重,治疗时宜参考药敏结果合理选用抗生素。

Antibiotic-resistant spectra of Carbapenem-resistant and Carbapenem-sensitive clinical isolates of Pseudomonas aeruginosa

Objective To investigate the distribution of carbapenem-resistant Pseudomonas aeruginosa (PA) and the comparative responses with other sensitive ones to antibiotics. Methods Dilution method was used to test the sensitivities to antibiotics of clinical isolate carbapenem-resistant and carbapenem-sensitive PA between January and December of 2004. Results Totally 28 strains of carbapenem-resistant PA were isolated from neursugical ward, respiratory intensive care Unit (RICU) and intensive care unit (ICU) and most of them were obtained from sputum culture(88.3%). Results of susceptibility test showed that carbapenem-resistant PA was highly resistant to Cefepime, Ceftazidime, etc than the sensitive ones. Conclusion Carbapenem-resistant PAs show multidrug resistance. To control this kind of infection, we must choose antibiotic rationally according to the result of sensitivi- ty test.