耐亚胺培南铜绿假单胞菌医院感染现状及耐药性分析  

Nosocomial infection and drug resistance analysis of imipenem-resistant Pseudomonas aeruginosa

作　　者：李红玉[1] 吴爱武[2] 

机构地区：[1]中山医科大学第二附属医院检验科,5101201 [2]广州医学院检验系

出　　处：《江西医学检验》2006年第3期193-194,206,共3页Jiangxi Journal of Medical Laboratory Sciences

基　　金：广州市教育局资助项目(1044)

摘　　要：目的探讨耐亚胺培南铜绿假单胞菌(imipenemresistantPseudomonasaeruginosa,IRPA)医院感染现状及其对临床常用抗菌药物的耐药情况,以指导临床更有效地使用抗生素。方法按常规方法对163株铜绿假单胞菌进行分离培养,VITEK-II全自动细菌鉴定仪进行鉴定,按2005年NCCLS的标准用纸片扩散(K-B)法对临床常用的抗菌药物进行药物敏感性试验,采用whonet5.3及SPSS11.0软件对数据进行统计处理。结果共分离出IRPA60株,占36.8%(60/163);主要来源于痰标本占66.7%(40/60),IR-PA在病区的分布中居前3位依次为ICU、呼吸内科和神经内科,IRPA对12种常用抗生素的耐药率除阿米卡星35.0%,庆大霉素45.0%外,对头孢吡肟、哌拉西林等10种抗菌药的耐药率均高于50.0%;除环丙沙星、庆大霉素,IRPA组的耐药率明显高于亚胺培南敏感铜绿假单胞菌(imipenemsusceptiblePseu-domonasaeruginosa,ISPA)组,差异有显著性(P<0.05)。结论IRPA对大多数临床常用抗生素呈现出多重耐药,且IRPA比ISPA具有更强的耐药性.Objective To study the nosocomial infection and drug resistance of imipenem resistant Pseudomonas aeruginosa （IRPA） isolated from the clinical samples to direct the use of antibiotics. Methods The strains were isolated and cuhured in routine procedures, and identified by VITEK-Ⅱ. Antibiotic sensitivity tests （AST） were proceeded by disc-diffusion （K-B） method, the results were analysed by Whonet 5.3 and SPSS11.0 software according to guidelines made by National Committee of Clinical Laboratory Standards. Results 60 strains of IRPA among 163 strains of pseudomonas aeruginosa, most of them were sputum（66.7%）, were isolated from ICU, respiratory disease and neurosurgery wards, Except Amikacin （35%） and Gentamicin （45.0%）, Resistant rates of IRPA to 10 common antibiotics were over 50.0%, and the resistant rate of IRPA group was obviously higher than that of the ISPA group except gentamicin and ciprofloxacin, the difference was significant （P 〈 0.05）. Conclusions IRPA showed multi-drug resistance, and demonstrate higher resistance to the antibiotics for ordinary use contrasting ISPA.

关 键 词：亚胺培南耐药 铜绿假单胞菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] Q939.92[医药卫生—临床医学]