铜绿假单胞菌近7年的耐药性变迁及其抗生素应用分析

目的分析铜绿假单胞菌近7年的耐药性变迁情况。方法收集2001年1月至2007年6月我院分离的铜绿假单胞菌1076株,分析其耐药性变迁及临床抗生素的应用情况;结果对铜绿假单胞菌保持抗菌活性较强而耐药率30%的抗菌药物依次为美罗培南、亚胺培南及阿米卡星,对常用抗菌药物的耐药率有普遍增高的趋势;抗铜绿假单胞菌所用抗生素单用455例(44.4%);二联521例(50.9%);三联48例(4.7%)。结论铜绿假单胞菌耐药率高,耐药率有普遍增高的趋势;对严重铜绿假单胞菌感染、多药耐药(MDRP)或泛耐药(PDRP)的治疗,宜采用联合用药,β-内酰胺类+阿米卡星为较优化的组合治疗方案之一。

Analysis of dug resistance diversity of peudomonas aeruginosa and the use of antibiotic from the years of 2001 to 2007

Objective To investigate drug resistance diversity of Pseudomonas aeruginosa and the use of antibiotic in a university-affiliated hospital from Jan 2001 to Jun 2007, so as to provide the reference for reasonable selection of antimicrobials and decrease the antibacterial resistance rate and the mortality. Methods A total of 1076 clinical Pseudomonas acruginosa isolates were detected and retrospectively analyzed. The bacteria isolation and antimierobial susceptibility testing were done by BioMerieux VITEK32 system,and supplemented by disk diffusion test（ Kirby-Bauer method）when necessary. SPSS 13.0 Software was used to analyze the data. Results There was an elevated tendency of the resistance rates to common antibacterial in Pseudomonas aeruginosa for the past seven years. The resistance rates to memropenen, imipene, amikacin were less than 30% , and cefoperazonc/sulb＇aetam, tobtanlyein, piperacillin/tazobaetam, eefepime and ecftazidime were between 30% - 50%. The resistant rates of Pseudomonas aeruginosa to many antimierobial drugs increased year by year. Among the treatment of pseudomonas aeruginosa infection,455 cases of single regimen accounted for 44.4% ;while 521 cases of the twodrug regimen made up 50. 9%. Only 48 cases were the three-drug regimen. Conclusion The antimierobial resistance of pseudomonas aeruginosa is high and its multi-drug resistance is severe, with an increasing tendency. When dealing with severe patients infected by pseudomonas aeruginosa, MDRP or PDRP, the combination of β-lactam antibiotics and amikaein is one of the rational therapeutic regimens.