神经外科重症监护室铜绿假单胞菌基因分型和耐药性研究

目的 建立随机扩增多态性DNA（RAPD）基因分型方法监测神经外科重症监护室（ICU）铜绿假单胞菌（PA）医院感染并进行耐药性分析。方法 收集自2004年至2005年ICU内分离出的75株PA，提取DNA后进行RAPD分型，同时进行抗生素敏感性实验。结果 75株PA共得14型，其中有3株属于同一种类型；抗生素敏感性实验表明PA对氨基糖苷类和环丙沙星等耐药率呈明显上升趋势，75株均为对亚胺培南／西司他丁，头孢哌酮／舒巴坦等少数几种敏感的多重耐药株。结论 ICU内存在PA感染爆发流行；了解PA的耐药现状，有利于为临床合理用药提供依据。

Genotyping and drug resistance of Pseudomonas aeruginosa in Intensive Care Unit of Neurosurgical Department

Objective To establish the randomly amplified polymorphic DNA (RAPD) assay for Pseudomonas aeruginosa (PA) and to explore the resistance of PA to antibiotics in Intensive Care Unit (ICU). Methods From the 75 strains of PA collected from ICU during 2004 to 2005, DNA was extracted and genotyped by RAPD; in addition, antibiotic susceptibility testing was also performed. Results The 75 strains of PA were distinguished into 14 kinds of RAPD type, and 3 strains had the same profiles; antibiotic susceptibility testing indicated the drug resistance rates of aminoglycosides, ciprofloxacin appeared an increasing trend; all of the 75 strains were multi-drug resistant and only susceptible to a few antibiotics such as imipenem/cilastatin and cefoperazone/sulbactam. Conclusion Outbreak of PA may occur in ICU. The status of resistance of PA must be investigated in order to provide evidence for clinical drug utilization.