综合医院耐碳青霉烯铜绿假单胞菌的耐药性分析  

Drug resistance analysis of carbapenem-resistant Pseudomonas aeruginosa in general hospitals

作　　者：李梦薇[1] 韦柳华[1] 莫善颖[1] 彭华[1] 黄志卓[1] 蒋利君[1] 

机构地区：[1]广西医科大学第四附属医院,广西柳州545005

出　　处：《现代预防医学》2013年第18期3454-3456,共3页Modern Preventive Medicine

基　　金：广西壮族自治区科学技术厅项目(桂科攻1140003A43);广西壮族自治区卫生厅项目(Z 2011497)

摘　　要：目的了解耐碳青霉烯铜绿假单胞菌的耐药性和分布,为临床合理用药提供依据。方法药敏试验采用K-B法,以美国临床实验室标准委员会(CLSI)2011年版为判断标准,采用WHONET 5.4软件对药敏结果进行统计分析。结果 52株非重复分离的耐碳青霉烯铜绿假单胞菌主要标本来源为呼吸道分泌物,占78.9%;病区分布重症监护病房所占比例最大,达到46.2%;头孢噻肟耐药率最高,达90.4%,其次为氨曲南、哌拉西林、头孢吡肟、左氧氟沙星,耐药率均超过65.0%,泛耐药铜绿假单胞菌分离率为3.8%。结论耐碳青霉烯铜绿假单胞菌耐药形势严峻,临床应在药敏结果指导下合理用药,慎重使用碳青霉烯类抗生素。OBJECTIVE Drug resistance and distribution of carbapenem-resistant Pseudomonas aeruginosa were studied, aiming to provide insight into the rational use of antibiotics in clinical practices. METHODS The Kirby-Bauer method was used to test antibiotic susceptibility, which was determined based on the standards published by the Clinical and Laboratory Standards Institute （CLSI） in 2011. Analysis of the results was carried out by the WHONET 5.4 software. RESULTS The majority of the 52 strains of non-repeatedly isolated carbapenem-resistant Pseudomonas aeruginosa was from the respiratory tract and the intensive care unit （ICU）, accounting for 78.9% of the tested specimens and 46.2% of the sampled locations, respectively. Among the antibiotics tested for drug susceptibility, up to 90.4% of the isolated P. aeruginosa was cefotamine resistant, and over 65.0% were resistant to aztreonam, piperacillin, cefepime, and levofloxacin. The isolation rate of pandrugresistant P. aeruginosa （PDR-Pa） was 3.8%. CONCLUSION Drug resistance of carbapenem-resistant Pseudomonas aeruginosa has been a serious clinical concern. It is suggested that the prescription of antibiotics should be based on drug susceptibility results, and that the use of carbapenems must be rational and cautious.

关 键 词：铜绿假单胞菌 碳青霉烯类 耐药 

分 类 号：R197.3[医药卫生—卫生事业管理]