多重耐药铜绿假单胞菌感染的危险因素及耐药性分析  

Rish factors and drug resistance of nosocomial infections caused by multidrug resistant Pseudomonas aeruginosa

作　　者：邓芳[1] 张健[1] 张世勇[2] 彭其胜[1] 舒德忠[1] 穆瑶[1] 

机构地区：[1]重庆市涪陵中心医院药剂科,408000 [2]重庆市涪陵中心医院检验科,408000

出　　处：《重庆医学》2013年第35期4304-4306,共3页Chongqing medicine

基　　金：涪陵区科技项目资助课题(FLKJ;2012ABB1098)

摘　　要：目的分析多重耐药铜绿假单胞菌(MDRP)感染的危险因素及耐药情况,为临床抗感染治疗提供依据。方法采用回顾性分析方法,对2010年9月至2011年12月分离的铜绿假单胞菌对临床常用抗菌药物的耐药性及易感因素进行分析。结果共收集到院内感染铜绿假单胞菌235株,其中MDRP 97株,总分离率为41.28%。重症监护病房(ICU)和神经外科分离率较高,分别占35.54%和22.31%;主要标本来源是呼吸道标本,占75.21%;MDRP耐药十分严重,对阿米卡星耐药率最低37.11%,其次哌拉西林/他唑巴坦、头孢他啶,分别为47.42%和48.45%,其余的均大于50.00%;通过分析发现,高龄、基础疾病重、住院时间长、长期反复应用广谱抗菌药物、入住ICU、各种侵入性治疗操作均为MDRP耐药的危险因素。结论应加强医院感染管理及耐药性监测,合理选用抗菌药物,防止交叉感染,以减少耐药菌株的产生及传播。Objective To analysis the risk factors and drug resistance of multidrug-resistant pseudomonas aeruginosa（MDRP） infection and to provide the basis for clinical anti-infective therapy.Methods Predisposing factors and drug resistance to clinical commonly used antibacterial drugs of MDRP which were separated from September 2010 to December 2011 were adopted for retrospective analysis.Results A total of 235 hospital MDRP infection were collected,97 multidrug resistant strains were concluded,the separation rate was 41.2%.The separation rate of ICU and neurosurgery were higher,account for 35.54% and 22.31%respectively.The main resource of specimen is respiratory tract,about 75.21%.The resistance of MDRP was very serious.The resistant rate of Amikacin was the lowest,account for 37.11%,followed by piperacillin/tazobactam,ceftazidime,account for 47.4% and 48.45% respectively.The resistant rate of other antimicrobial agents were greater than 50%.Advanced age,serious underlying diseases,long hospital stay,long-term repeated application of broad-spectrum antimicrobial drugs,admission to ICU,invasive treatment operations were the risk factors for MDRP resistance.Conclusion The resistance is very serious,in order to reduce the generation and spread of drug-resistant strains,the hospital infection control,drug resistance monitoring,rational use of antimicrobial drugs and prevention of cross-infections should be strengthened.

关 键 词：假单胞菌 铜绿 抗药性 微生物 抗菌药 危险因素 

分 类 号：R446.5[医药卫生—诊断学]