某综合医院铜绿假单胞菌2005-2009年耐药性的变迁

目的了解某综合医院2005-2009年铜绿假单胞菌临床分离株的耐药性变迁,为合理应用抗菌药物提供依据。方法应用回顾性调查方法,对广东省汕头市某综合医院2005-2009年住院病人送检标本中分离的铜绿假单胞菌的药敏试验结果进行统计分析。结果 5年间共检出铜绿假单胞菌1809株,总的分离率为16.34%;标本分布以痰液来源为主,占84.9%;几年间铜绿假单胞菌对氨苄西林、复方新诺明、呋喃妥因、头孢唑啉的耐药率变化不大,对阿米卡星、庆大霉素、妥布霉素、亚胺培南、头孢他啶、头孢吡肟、环丙沙星、左旋氧氟沙星等抗菌药物的耐药率均在2007年达到高峰,在2008、2009年两年间呈连续下降趋势。从2009年的情况来看,耐药率最低的是妥布霉素,为28.97%（168/580）,其次为阿米卡星和左旋氧氟沙星,分别为32.07%（186/580）和33.97%（197/580）。结论铜绿假单胞菌对大多数抗菌药物的耐药率有所下降,但总体耐药情况还是比较严重。

A study on the drug resistant Pseudomonas aeruginosa in a comprehensive hospital between 2005 and 2009

Objective To investigate the distribution of drug resistant Pseudomonas aeruginosa in a comprehensive hospital between 2005 and 2009,in order to provide the basis for rational use of drugs.Methods Retrospective study was applied to analyze the drug sensitivity of P.aeruginosa isolated from the specimens of inpatients between 2005 and 2009.Results A total of 1 809 P.aeruginosa,accounting for 16.34% of the total isolates,were isolated.These strains were mainly cultured from sputum（84.9%）.There was a little change in the resistance to ampicillin,sulfamethoxazole,nitrofurantoin and cefazolin.An increase in resistance to amikacin,gentamicin,bramycin,imipenem,ceftazidime,cefepime,ciprofloxacin,and levofloxacin was noted in 2007,and the resistance to these drugs decreased in 2008 and 2009.In 2009,the resistant rate to bramycin was lowest（28.97%,168/580）,followed by amikacin（32.07%,186/580） and levofloxacin（33.97%,197/580）.Conclusion Although the drug resistance of P.aeruginosa was slightly decreased,the overall situation in this hospital is still fairly severe.