421株医院感染铜绿假单胞菌的耐药性分析

目的:了解我院铜绿假单胞菌(PAE)对常用抗菌药物的耐药现状及标本分布。方法:采用法国生物梅里埃生物API鉴定系统进行鉴定,并采用K-B纸片扩散法进行体外耐药检测及统计耐药率。结果:临床分离的421株PAE在ICU和呼吸内科感染率最高,占总构成比的79.8%。PAE除对头孢吡肟、复方新诺明和四环素敏感外(敏感率为100%),对其它多种抗菌药物均表现不同程度的耐药现象。如对不含酶抑制剂的三代头孢类药物头孢曲松、头孢噻肟、头孢他啶以及氨基糖苷类的庆大霉素普遍存在较高的耐药率(耐药率为50.0%),其次为喹诺酮类的药物如环丙沙星、左氧氟沙星和氨基糖苷类的阿卡米星(>20.0%),而在本院尚且保持较高敏感性的药物有头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和亚胺培南,其耐药率均未超过10.0%。结论:PAE是医院感染的主要病原菌之一,加强其耐药性检测,规范抗菌药物的应用,对保持敏感抗菌药物的抗菌活性具有重要意义。

Analysis of Nosocomial Infection with 421 Strains of Pseudomonas Aeruginosa and the Approach of Drug Resistance

Objective:To investigate the distribution and situation of drug resistance of pseudomonas aeruginosa isolated from our hospital.Methods:The microbilogical system API was used to indentify pseudomonas aeruginosa while the drug resistance in vitro was determined by K-B methods.Results:Most of pseudomonas aeruginosa were found in the department of respiratory internal medicine and ICU,they almost accounted for 79.8%.Pseudomonas aeruginosa was sensitive to cefepime,bactrim and ambramycin,but to other drugs it showed different degrees of drug resistance.For example,the resistance rate of pseudomonas aeruginosa to the third generation cephalosporins(ie.ceftriaxone,cefotaxim,ceftazidime) and gentamicin that belongs to aminoglycosides,were as high as 50.0%,and then it came to be the FQNS(ie.ciprofloxacin and levofloxacin) and amikacin,the resistance rate was more than 20.0%.However,in our hospital cefoperazone/sulbactam,piperacillin/surname and imipenem still maintained a higher sensitivity to the pseudomonas aeruginosa,their resistance rate were lower than 10.0%.Conclusion:Pseudomonas aeruginosa is one of the main pathogenic bacteria in nosocomial infection,so reinforce the monitoring on the drug resistance of pseudomonas aeruginosa and to standardize the application of antibacterials are helpful to maintaining antibacterial activity of sensitive antibacterials.