医院感染铜绿假单胞菌的耐药性变迁及临床对策

目的 探讨铜绿假单胞菌(PAE)医院感染的耐药性及其变迁,为临床合理用药提供依据.方法 对医院2008年1月-2010年12月住院患者各种标本中分离到的铜绿假单胞菌175株,采用13种抗菌药物进行药敏试验.结果 痰液中PAE检出率最高占65.7％,其次是脓液标本占17.1％,尿液标本占10.3％;PAE对头孢他啶、头孢吡肟、环丙沙星、左氧氟沙星耐药率均＜20.0％,对头孢噻肟、头孢曲松的耐药率均＞40.0％,最敏感的是阿米卡星、妥布霉素,对亚胺培南/西司他丁的耐药率为21.3％.结论 医院感染铜绿假单胞菌的临床检出率呈逐年上升趋势,且对多种抗菌药物具有耐药性,临床抗感染治疗应根据体外药敏试验结果选用抗菌药物.

Change of drug resistance of Pseudomonas aeruginosacausing nosocomial infections and clinical countermeasures

OBJECTIVE To investigate the change in antibiotic resistance of Pseudomonas aeruginosa causing nosocomial infections so as to provide basis for clinical reasonable use of antibiotics.METHODS A total of 175 strains of P.aeruginosa isolated from various clinical specimens from Jan 2008 to Dec 2010 were collected.The drug susceptibility testing for 13 antimicrobial agents was performed.RESULTS The detection rate of P.aeruginosa isolated from sputum was the highest(65.7%),followed by pus specimens(17.1%) and urine samples(10.3%);the drug resistance rates of P.aeruginosa to ceftazidime,cefepime,ciprofloxacin and levofloxacin were less than 20.0%,the drug resistant rates to cefotaxime and ceftriaxone were higher than 40.0%,P.aeruginosa was most susceptible to amikacin and tobramycin,the drug resistance rate to imipenem was 21.3%.CONCLUSION The isolation rate of P.aeruginosa causing nosocomial infections keeps increasingly upward tendency,and P.aeruginosa is multidrug-resistant,it is necessary to choose antibiotics for clinical anti-infection therapy in accordance with the result of in vitro drug susceptibility testing.