ICU分离的铜绿假单胞菌血清分型及耐药性分析  

Serotyping and drug resistance of Pseudomonas aeruginosa isolated from ICU

作　　者：刘冰[1] 贾淑梅[1] 徐修礼[1] 孙怡群[1] 

机构地区：[1]第四军医大学西京医院,陕西西安710032

出　　处：《中国感染控制杂志》2006年第3期247-249,共3页Chinese Journal of Infection Control

摘　　要：目的确定重症监护室(ICU)铜绿假单胞菌流行菌株血清型别及其对抗菌药物的耐药情况,为研究铜绿假单胞菌感染的控制措施,合理应用抗菌药物提供依据。方法采用日本生研株式会社的铜绿假单胞菌血清分型试剂盒,对某院呼吸内科、神经内科、麻醉科ICU住院患者痰液及相关环境标本中分离的铜绿假单胞菌进行血清学分型及耐药性监测。结果3个ICU共检出铜绿假单胞菌88株,对其中80株进行了血清学分型,分型率90.91%;所占比率较大的血清型为:B型52.27%,G型22.73%,未分型菌9.09%。各型对10种抗菌药物的耐药种类数为:B与G型10种,未分型菌9种,D与E型8种,F型7种,I,M与K型<3种;铜绿假单胞菌对10种抗菌药物总的耐药率分别为:头孢曲松67.05%,阿洛西林61.36%,头孢吡肟44.32%,替卡西林/他唑巴坦54.55%,阿米卡星56.82%,头孢哌酮46.59%,左氧氟沙星54.55%,头孢哌酮/舒巴坦6.82%,亚胺培南55.68%,头孢他啶28.41%;B型菌的耐药率高于其他各型。结论该院ICU铜绿假单胞菌血清分型以B型为主;以多重耐药菌株多见;对头孢哌酮/舒巴坦和头孢他啶耐药率较低,此两种药可作为铜绿假单胞菌感染治疗的首选药物。Objective To survey the epidemic serotypes and drug resistance of Pseudomonas aeruginosa isolated from ICU, so as to provide reference for the rational use of antimicrobial agents for the control Of infection with Pseudomonas aeruginosa. Methods Serotypes and drug resistance of Pseudomonas aeruginosa isolated from environment and patients＇ sputum in ICU of respiratory, neurological, anesthetic departments were detected by Pseudomonas aeruginosa serotyping kit. Results Eighty-elght strains of Pseudomonas aeruginosa were isolated from 3 ICU, 80 of which were serotypied, the serotyping rate was 90.91%. 52.27 %, 22.73 % and 9.09 % was type B, G and untyped strains respectively. The resistant drug kinds were as follows： types B and G were resistant to 10 antimicrobial agents, untypied strains to 9, D and E to 8, F to 7, I, M and K to 〈 3 kinds of antimicrobial agents; the total resistant rates of Pseudomonas aeruginosa to 10 kinds of antimicrobial agents were as follows： 67.05% to ceftriaxone, 61.36% to azlocillin, 44.32% to cefepime, 54.55% to ticarcillin/tazobactam, 56.82% to amikacin, 46.59% to cefoperazone, 54.55% to levofloxacin, 6.82% to cefoperazone/sulbactam, 55.68% to imipenem and 28.41% to ceftazidime, the resistant rate of type B strains was higher than the other strains. Conclusion Serotype B strains of Pseudomonas aeruginosa are the main bacteria isolated from ICU in this hospital, most of which are multiply drug resistant strains; the resistance to cefoperazone/sulbactam and ceftazidime is low, which can be used as the first choice antimicrobial agents for the treatment of infection with Pseudomonas aeruginosa.

关 键 词：重症监护室 铜绿假单胞菌 血清学试验 抗药性 微生物 

分 类 号：R378.991[医药卫生—病原生物学]