311株铜绿假单胞菌感染与耐药分析

目的:研究铜绿假单胞菌感染现状、分布特征及其耐药性,指导临床合理用药。方法:收集四川大学华西医院2003年1月~2003年12月临床分离铜绿假单胞菌311株,用美国DADE BEHRING公司Microscan walkAway40型全自动细菌鉴定分析系统对临床标本中分离的铜绿假单胞菌进行鉴定,并采用MIC法对临床分离铜绿假单胞菌选用13种抗菌药物进行敏感性测定。分析其感染分布、耐药性与多重耐药性。结果:共检出311株铜绿假单胞菌。感染部位依次为呼吸道、血液、胆汁、伤口等。耐药率:头孢吡肟(11.6%)、哌拉西林-他唑巴坦(11.6%)、阿米卡星(11.6%)、头孢哌酮-舒巴坦(16.1%)、环丙沙星(23.8%)、哌拉西林(24.8%)、庆大霉素(29.3%)、妥布霉素(30.1%)头孢他啶(30.9%)、氨曲南(33.4%)、亚胺培南(34.4%),其余抗生素耐药率更高。耐药菌株存在较严重的交叉耐药及多重耐药现象。结论:铜绿假单胞菌耐药及多重耐药现象严重,应加强对铜绿假单胞菌耐药性的监测,合理使用抗菌药物,以减少耐药菌株的出现和扩散。

Investigation of Pseudo-Aeruginosa Infection and Drug Resistance:Report of 311 Cases

Objective:To investigate the present condition of infection,feature of distribution and drug resistance of the Pseudomonas aeruginosa,and to guide our rational drug administration in clinical practice.Method:Three hundred and eleven plants of the Pseudomonas aeruginosa were collected,isoluted from the clinical specimens in West China Hospital of Sichuan University,from January 2003 to December 2003.These bacteria were identified by the full-automatic bacteria identification-analysis system,Microscan walk away type 40 from American DADE BEHRING Corporation.Their susceptibility was detected by 13 antibacterial drugs by MIC.Then the distribution of infection,drug resistance and multi-drug resistance(MDR) were analysed.Results:Three hundred and eleven plants of the Pseudomonas aeruginosa were detected in total.The positions of infection were respiratory tract,blood,bile,wound,in sequence.Drug-resistant rate: Cefepime(11.6%),Piperacillin-Tazobactam(11.6%),Amikacin(11.6%),Cefoperazone-Sulbactam(16.1%),Ciprofloxacin(23.8%),Piperacillin(24.8%),Gentamicin(29.3%),Tobramycin(30.1%),Ceftazidime(30.9%),Aztreonam(33.4%),Imipenem(34.4%);the others' were higher.Resistant patterns had rather serious phenomenon of cross resistance and MDR.Conclusion:The Pseudomonas aeruginosa has serious phenomenon of resistance and MDR.In order to decrease the spread of resistant strains it is important to strengthen the surveillance of the resistance of the Pseudomonas aeruginosa,and to administrate antibacterial drugs rationally.