鲍曼不动杆菌和铜绿假单胞菌在医院感染中的地位及耐药分析

目的了解鲍曼不动杆菌和铜绿假单胞菌在医院感染中的地位,分析其对临床常用抗菌药物的耐药情况。方法鲍曼不动杆菌和铜绿假单胞菌的鉴定和药敏采用法国生物梅里埃公司的VITEK-2系统进行药物的最低抑菌浓度(M IC)检测。结果铜绿假单胞菌和鲍曼不动杆菌在医院感染中是重要的致病菌。在呼吸道感染标本中铜绿假单胞菌和鲍曼不动杆菌分别位居前一、二。对铜绿假单胞菌仍保持较高的抗菌活性的抗菌药物(耐药率均<20%)有阿米卡星、头孢他啶、环丙沙星、亚胺培南、妥布霉素、头孢吡肟、左旋氧氟沙星、哌拉西林/他唑巴坦、美洛培南。对鲍曼不动杆菌仍保持较高的抗菌活性的抗菌药物(耐药率均<20%)只有阿米卡星和亚胺培南。耐亚胺培南鲍曼不动杆菌的耐药性很高,除阿米卡星耐药率是28.4%外,其余的抗菌药物的耐药率均高于60%。结论虽然耐亚胺培南鲍曼不动杆菌的多重耐药性比耐亚胺培南铜绿假单胞菌更为显著,但鲍曼不动杆菌和铜绿假单胞菌在我院的医院感染菌中的地位同样重要,在医院感染的防控中值得关注。

Role of Acinetobacter baumannii and Pseudomonas aeruginosa in nosocomial infection and their drug-resistance

Objective To get a comprehensive understanding of the role of Acinetobacter baumannii（A.baumannii） and Pseudomonas aeruginosa（P.aeruginosa） in the nosocomial infections in the First Municipal People＇s Hospital of Guangzhou,and investigate drug-resistance of these two pathogens to common antibiotics.Methods Biomerieux＇s VITEK-2 system was used to identify pathogens and drug susceptibility.Results A.baumannii and P.aeruginosa were the main bacterial pathogens of nosocomial infection in our hospital.The isolation of P.aeruginosa was most common followed by A.baumannii in respiratory infection samples.P.aeruginosa was relatively susceptible to the common antibiotics such as amikacin,ceftazidime,ciprofloxacin,imipenem,tobramycin,cefepime,levofloxacin,piperacillin-tazobactam,and meropenem（resistance rate 20%）.Among the antibiotics tested,amikacin and imipenem were active against A.baumannii（resistance rate 20%）.There were high resistance rate and cross resistance in imipenem-resistant A.baumannii.Conclusion Although the multidrug resistant and resistance rate in imipenem-resistant A.baumannii are higher than imipenem-resistant P.aeruginosa,both A.baumannii and P.aeruginosa are important pathogenic bacteria isolated from infected samples in local hospital.