重症监护病房与普通病房铜绿假单胞菌感染的耐药性对比研究

目的 通过对比重症监护病房（ICU）与普通病房铜绿假单胞菌（PA）的细菌耐药性,为临床合理用药提供依据.方法 对2003年7月～2004年12月ICU与普通病房233株PA（ICU81株、普通病房152株）的体外药敏活性进行分析.结果 ICU较普通病房耐药率明显升高（P〈0.005）.PA对8种常用抗生素的耐药率ICU为：亚胺培南16.25%、环丙沙星18.18%、阿米卡星44.73%、氨曲南57.74%、头孢他啶61.03%、头孢哌酮-舒巴坦64.06%、左氧氟沙星71%、哌拉西林-三唑巴坦73%、哌拉西林77.94%.普通病房为：亚胺培南5.36%、环丙沙星9.75%、氨曲南16.86%、头孢哌酮-舒巴坦17.02%、头孢他啶20%、阿米卡星26.86%、哌拉西林-三唑巴坦39%、哌拉西林40.97%、左氧氟沙星46%.ICU与普通病房中PA株对亚胺培南的耐药率R〈10%.对亚胺培南耐药的PA株对其他多种抗生素也表现较高的耐药率（R〉38.00%）,但对其他多种抗生素耐药的PA株尚保留了对亚胺培南的敏感性（R〈24.3%）.结论 PA对多种抗生素耐药,尤其在ICU,PA耐药性明显高于普通病房.针对PA,亚胺培南在ICU和普通病房都是一可靠而有效的抗生素.

A control study on bacterial resistance with Pseudomonas aeruginosa in medical intensive care unit and general wards

Objective To compare bacterial resistance with pseudomonas aeruginosa(PA) in medical intensive care units(MICU) and general wards(GW) and to analyze the predisposing factors to PA infection.Methods The susceptibility patterns to antibiotics of 233 PA strains(81 from MICU and 152 from GW) from the recorders of the bacteria culture chamber from July 2003 to December 2004 were investigated.Results Most of the resistant rates of strains from MICU were higher than those from GW(P<0.005): imipenem 9.3%(MICU 16.25% GW5.36%),ciprofloxacin 12%(MICU 18.8% GW 9.75%),amikacin 33.7% (MICU 44.73% GW 26.86%),aztreonam 30%(MICU57.74% GW 16.08%),ceftazidime 34.4%(MICU61.03% GW 20%),cefoperazone-sulbactam 31.7%(MICU 64.06% GW 17.02%),levofloxacin 51.92%(MICU 70% GW46%),piperacillin/tazobactam 50%(MICU 72% GW 39%),piperacillin 53%(MICU 77.94% GW 40.97%).On the other hand,a relatively high resistant rates of PA strains to other antibiotics resists were found in these PA strains to imipenem resists(R>38%),but a relatively high susceptibilities of PA strains to imipenem susceptibilities(R<24.3%) were found in these PA strains to other antibiotics resists.Conclusion The resistant rates of PA were higher in MICU than GW,to PA infection imipenem is effective in MICU and GW.