气管切开病人铜绿假单胞菌感染及耐药分析  

DRUG RESISTANCE OF PSEUDOMONAS AERUGINOSA IN PATIENTS WITH TRACHEOSTOMY

作　　者：李霞[1] 

机构地区：[1]临沂市沂水中心医院,山东临沂276400

出　　处：《齐鲁医学杂志》2007年第3期237-238,240,共3页Medical Journal of Qilu

摘　　要：目的 探讨气管切开病人铜绿假单胞菌（PA）感染情况及对16种常用抗生素的耐药情况。方法 对气管切开病人128例，非机械通气病人（对照组）560例，均采用常规方法培养、分离鉴定细菌，同时用Kirby—Bauer法进行药敏试验。结果 气管切开组病人PA感染率和耐药率明显高于对照组，对抗生素阿米卡星、环丙沙星、哌拉西林、头孢哌酮钠、头孢吡肟的耐药率高于对照组，差异有显著性（χ^2=3．279～20．217，P〈0．05）；两组PA对氨苄西林、头孢唑啉钠、头孢西丁、头孢噻肟钠、头孢曲松钠的耐药率均大于80％，差异均无统计学意义（P〉0．05）。结论 气管切开病人PA感染率及对常用抗生素耐药率显著增加，应重视细菌培养和药敏试验，β-内酰胺-酶抑制复合剂可作为首选药物有效地控制耐药菌株传播，从而降低由PA引起的院内感染。Objective To analyze drug resistance of pseudomonas aeruginosa （PA） in patients undergoing tracheostomy. Methods Specimens were obtained from 128 patients and 560 cases with no mechanical ventilation （control group）. Bacteria strains were isolated and cultured, and antimicrobial susceptibility were detected by K-B method. Results The PA infection rate and total drug resistance rate were both significantly higher in the patients than that in the control （χ^2= 20.2, P〈0.05）. The drug resistance rate of arnikacin, piperacillin, cefoperazone, cefepime and ciprofloxacin was significantly higher in the patients than that in the control （P〈0.05）. The drug resistance rate of ampicillin, cefazolin, cefoxitin, cefotaxime and ceftriaxiome was all higher than 90% in both groups （P〉0.05）. Conclusion The infection and drug resistance rates of pseudomonas aeruginosa are both significantly higher in patients with tracheostomy than the control group. Antibiotics should be chosen based on susceptibility analysis, and beta-lactamase inhibitor preparations should be considered first to reduce nosocomial infection caused by pseudomonas aeruginosa.

关 键 词：假单胞菌 铜绿 气管切开术 抗药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]