老年呼吸机相关性肺炎感染铜绿假单胞菌的耐药性分析  

Drug resistance of Pseudomonas aeruginosa causing ventilator-associated pneumonia in elderly patients

作　　者：吴丽丽[1] 王丽君[1] 胡勤辛[1] 沈世恩[1] 于小妹[1] 

机构地区：[1]浙江医院检验科,浙江杭州310013

出　　处：《中华医院感染学杂志》2012年第11期2431-2433,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究老年呼吸机相关性肺炎(VAP)铜绿假单胞菌(PAE)感染及耐药特征,为临床合理选用抗菌药物提供依据。方法对256例使用呼吸机治疗的老年住院患者进行目标监测,对分离的铜绿假单胞菌采用纸片扩散法进行药敏试验,并对抗菌药物耐药结果进行回顾性分析。结果 63株铜绿假单胞菌对阿米卡星的耐药率最低,为23.81%,其次为庆大霉素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南、左氧氟沙星,耐药率为34.92%～53.97%,对其余8种抗菌药物的耐药率为55.56%～100.00%;共检出34株耐亚胺培南PAE,3株泛耐药菌株。结论铜绿假单胞菌对常用抗菌药物呈多药耐药;VAP感染已十分严重,应引起临床医师的重视;治疗应选择科学的联合用药方案;首选药物为头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、美罗培南。OBJECTIVE To investigate the Pseudomonas aeruginosa infections in the elderly patients with ventilator-associated pneumonia （VAP）and the characteristics of drug resistance so as to provide bases for reasonable use of antibiotics. METHODS The target monitoring of 256 elderly hospitalize patients who were treated with ventilator was performed, the drug susceptibility testing for P. aeruginosa isolated was performed by disc diffusion method, the results were analyzed retrospectively. RESULTS Totally 63 P. aeruginosa isolates showed the lowest drug resistance to amikacin （23. 81%）, followed by gentamicin, cefoperazon/sulbactam, piperacillin/tazobactam, imipenem, meropenem and levofloxacin （varied from 34. 92% to 53. 97%）; the drug resistance rates to other antibiotics ranged from 55. 56% and 100. 00%; a total of 34 imipenem-resistant P. aeruginosa isolates and 3 pandrug-resistant strains were detected. CONCLUSION P. aeruginosa shows multidrug- resistance to commonly used antimicrobial agents. P. aeruginosa has been very severe, which should be attached great importance; it should choose the scientific combination use of antibiotics for the treatment; cefoperazon/ sulbactam, oiDeracillin/tazobactam,imiDenem, and meronenem are preferred antiobitcs for the treatment.

关 键 词：老年 呼吸机相关性肺炎 铜绿假单胞菌 耐药 

分 类 号：R378.991[医药卫生—病原生物学]