重症监护病房铜绿假单胞菌耐药性分析及对策

目的:分析ICU感染的铜绿假单胞菌耐药情况.方法:收集2007.7～2008.12入住ICU患者的基本资料及各类标本,标本进行细菌培养及药敏试验,对患者耐药情况进行分析.结果:共分离出199株铜绿假单胞菌菌株,美洛培南敏感率为96.2%、阿米卡星敏感率为69.6%、头孢哌酮/舒巴坦敏感率为65.4%、哌拉西林/他唑巴坦敏感率为61.6%、亚胺培南敏感率为57.2%、头孢吡肟敏感率为32.4%、头孢他啶敏感率为28.3%;通过分析发现,住院时间长、使用抗菌药物、侵入治疗、呼吸衰竭、手术等均为铜绿假单胞菌耐药的危险因素.结论:ICU铜绿假单胞菌耐药现象已十分突出,对多重耐药菌株的感染应以预防为主,建立耐药监控体系,控制耐药的发展及扩散.

Analysis and countermeasure of drug resistance Pseudomonas aeruginosa in ICU

Objective: To study and analysis the prevalence of drug resistance Pseudomonas aeruginosa infection in ICU. Methods: The samples were collected from the in-patients from 2007.7~2008.12. The pathogenic bacteria were cultured. Identification and antibiotic susceptibility were tested by Vitek 32 automatic bacterial analysis system. Results: Among total of 199 isolated strains of Pseudomonas aeruginosa, the drug sensitive rate were 96.2%, 69.6%, 65.4%, 61.6%, 57.2%, 32.4% and 28.3% for meropenem, amikacin, cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, cefepime, ceftazidime respectively. Conclusion: It was found that long-term inpatients, frequent use of antimicrobial drugs, invasive therapy, respiratory failure, surgery etc, are risk factors of antibiotic resistance in P. aeruginosa . It is important to enhance the asepsis in ICU, and to establish a drug resistance monitoring system to prevent hospital infection, detect the pathogenic bacteria and use antibiotics rationally.