重症监护病房患者下呼吸道感染铜绿假单胞菌的耐药性分析  

Drug Resistance of Pseudomonas aeruginosa Causing Lower Respiratory Tract Infection in Intensive Care Unit

作　　者：李政[1] 蒋冬香[1] 王玉春[1] 李霞[1] 

机构地区：[1]桂林医学院附属医院检验科,广西桂林541001

出　　处：《实用预防医学》2012年第10期1534-1535,1546,共3页Practical Preventive Medicine

基　　金：广西壮族自治区卫生厅计划课题(NO:Z2010297)

摘　　要：目的分析重症监护病房（ICU）患者下呼吸道感染铜绿假单胞菌耐药性的变化,指导临床合理用药。方法采用法国生物梅里埃公司ATB-Expression分析仪进行细菌鉴定,K-B法进行体外药敏试验。结果共检出铜绿假单胞菌239株,检出率为19.2%,铜绿假单胞菌对阿米卡星、亚胺培南耐药率分别为28.79%~31.58%、25.76%~30.53%,相对较低,而妥布霉素、头孢哌酮/舒巴坦、头孢他啶、哌拉西林/他唑巴坦、庆大霉素、头孢吡肟、哌拉西林、环丙沙星、氨曲南的耐药率分别为40.91%~45.26%、45.45%~50.53%、47.00%~52.63%、48.48%~54.74%、50.00%~57.89%、50.00%~58.95%、51.52%~56.84%、53.03%~57.89%、54.55%~67.37%,对复方新诺明的耐药率最高（83.33%~90.53%）,但这些抗生素近三年的耐药率无明显变化（P〉0.05）。结论下呼吸道感染铜绿假单胞菌的耐药现象严重,ICU应加强铜绿假单胞菌耐药性的监测,合理选用抗菌药物,以减少耐药株的出现与扩散。Objective To analyze the drug resistance of Pseudomonas aeruginosa isolated from patients with lower respiratory tract infection in intensive care unit（ICU）,and to guide reasonable clinical prescription. Methods ATB-Expression analysis system was used for the identification of bacteria.The drug resistance tests were performed by K-B method. Results Among 239 strains of identified P.aeruginosa,the results of susceptibility tests showed that the resistance rates to amicaxin and imipenem were relatively low（28.79%～31.58% and 25.76%～30.53%）,but the resistance rates to tobramycin,cefoperazone/sulbactam,ceftazidime,piperacillin/tazobactam,gentamicin,cefepime,piperacillin,cipr-ofloxacin,and aztreonam were 40.91%～45.26%, 45.45%～50.53%,47.00%～52.63%,48.48%～54.74%,50.00%～57.89%,50.00%～58.95%,51.52%～56.84%,53.03%～57.89% and 54.55%～67.37%,respectively.The resistant rate to SXT was the highest（83.33%～90.53%）.The resistance rates to these antibiotics in 2011 were not drastically higher than those in 2010 or 2009（P0.05）. Conclusions The resistance of P.aeruginosa isolated from lower respiratory tract infection is severe.In order to reduce or prevent the occurrence of drug resistant strains,we should monitor their drug resistance status,and select antibiotics rationally according to the results of susceptibility tests.

关 键 词：重症监护病房 下呼吸道感染 铜绿假单胞菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]