2008-2012年医院临床分离铜绿假单胞菌的耐药性分析  

Resistance Analysis of Pseudomonas Aeruginosa Isolated from Clinical Specimens during 2008 to 2012

作　　者：何卡乐[1] 刘弘[1] 魏伟[1] 徐丽娜[1] 

机构地区：[1]解放军第152中心医院,河南平顶山467099

出　　处：《中国药师》2014年第1期128-130,共3页China Pharmacist

摘　　要：目的：了解医院近年来铜绿假单胞菌的耐药性变迁,指导临床合理使用抗菌药物.方法：监测2008-2012年医院临床分离铜绿假单胞菌耐药状况,用Kirby-Bauer纸片扩散法检测细菌耐药性,参照2008-2012年版美国临床实验室标准化协会Clinical and Laboratory Standards Instyitite标准（CLSI）判定药敏结果,并用WHONE5.4软件统计分析.结果：5年中医院共收集临床分离的铜绿假单胞菌1 469株,其中78.8%的菌株分离来自呼吸道标本.各年间比较,铜绿假单胞菌分离率均列为第2位,且对12种抗菌药物的耐药率均较高,对头孢哌酮/舒巴坦的耐药率最低,平均为36.4%,对第三代头孢菌素头孢他啶、头孢哌酮的耐药率最高,平均在68.3%~87.0%.铜绿假单胞菌对亚胺培南的耐药率性平均为40.3%;对氨曲南的耐药率平均为64.6%,但其总体耐药率有下降趋势;对哌拉西林/他唑巴坦、阿米卡星、环丙沙星的平均耐药率分别为41.7%,49.6%,38.5%,无明显下降趋势.结论：铜绿假单胞菌的临床分离率较高,且有上升趋势,对常用抗菌药物的耐药率也较高,应加强抗菌药物的分级管理和细菌耐药性监测,指导临床合理使用抗菌药物并控制医院耐药菌感染的流行.Objective： To investigate the change in drug resistance of Pseudomonas aeruginosa in recent years in order to guide clinical rational use of antimicrobial agents. Methods： Bacterial resistance of Pseudomonas aeruginosa was detected by Kirby-Bauer disc diffusion method to survey the drug resistance status of the clinical isolated bacteria during 2008 and 2012, the drug susceptibility results were judged by CLSI standards （the 2012 version）, and WHONE5.4 software was used for statistic analysis. Results： The re- sults showed that 1469 strains of the clinical isolated Pseudomonas aeruginosa were collected during the past five years, and among them, 78.8% strains were isolated from respiratory tract specimens. During the past five years, the isolation rate of Pseudomonas aeruginosa was always in the second place and the drug resistance to 12 kinds of antibiotics was high. The average lowest resistance rate was 36.4% for cefoperazone/sulbactam, and the average highest resistance rate for the third generation cephalosporin ceftazidime, cef- operazone, ceftriaxone and cefotaxime was between 68.3% and 87.0%. The average drug resistance rate was 40.3% for imipenem, while 64.6% for aztreonam with a descending trend. The average drug resistance rate was respectively 41.7%, 49.6% and 38.5% for piperacillin/tazobactam, amikacin and ciprofloxacin without significant descending trend. Conclusion： Pseudomonas aeruginosa is highly separated in clinical test with a rising trend, and the drug resistance rate of Pseudomonas aeruginosa to some commonly used an- timicrobial agents is also in high level. Therefore, the classification management of antibiotics and bacterial resistance surveillance should be enhanced in order to provide the reference for clinical rational application and further control of the resistant bacterial infec- tion.

关 键 词：抗菌药物 铜绿假单胞菌 细菌耐药性 

分 类 号：R378.991[医药卫生—病原生物学]