医院感染铜绿假单胞菌临床分布及耐药性分析  

Clinical distribution and drug resistance analysis of Pseudomonas aeruginosa induced nosocomial infections

作　　者：尚旭明[1] 王盛华[1] 鞠瑛[1] 

机构地区：[1]山东大学附属省立医院检验科,山东省济南250021

出　　处：《中国基层医药》2014年第4期484-486,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：山东省优秀中青年科学家科研奖励基金（BS2010YY045）

摘　　要：目的 探讨医院感染铜绿假单胞菌（PAE）在临床标本中的分布及耐药性,为临床医师合理使用抗菌药物提供科学依据.方法 对分离到的铜绿假单胞菌258株,采用20种抗菌药物进行药敏试验.结果 铜绿假单胞菌医院感染主要发生在呼吸病房37.21%和重症加强护理病房18.60%,分离菌株最多的标本是痰液及咽拭子和脓液及伤口分泌物,分别占60.85%、15.12%,对铜绿假单胞菌敏感性最高的抗菌药物是亚胺培南89.96%和阿米卡星80.62%,其次是哌拉西林/他唑巴坦78.13%、美罗培南72.02%;耐药性最高是氨苄西林100.00%和头孢唑啉100.00%,其次是头孢替坦99.22%、阿莫西林/克拉维酸99.20%、呋喃妥因97.18%和氨苄西林/舒巴坦95.34%.结论 铜绿假单胞菌感染率高,且对常用多种抗菌药物具有高度耐药性,应加强监测,为临床抗感染治疗合理选用抗菌药物提供科学依据.Objective To analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa （PAE） in clinical specimens, so as to provide scientific basis for the rational use of antimicrobial agents for clinicians. Methods 258 Pseudomonas aeruginosa strains isolated from clinical specimens in our hospital were collected. Drug sensitivity to 20 antimicrobial agents were tested. Results The most of Pseudomonas aeruginosa specimens were collected from respiratory department and ICU, accounted for 37.21% and 18.60% , respectively. The most specimens were isolated from sputum/throat swab and pus/wound secretion, accounted for 60. 85% and 15.12%, respectively. The results of drug susceptibility test revealed that＇imipenem, amikacin, piperacillin/tazobactam and meropenem kept high antibacterial activity against PAE, and the susceptibility rates were 89.96%, 80.62%, 78.13% and 72.02%, respectively. The resistance rates of PAE to ampicillin, cefazolin, cefotetan, amoxicillin/clavulanic acid, nitrofurantoin and ampicillin/shubatan were 100.00%, 100.00% ,99.22% ,99.20% ,97.18% and 95.34%. Conclusion PAE is the main pathogen of the nosocomial infection bacteria with high infection rate and high antimicrobial resistance to multiple common antibacterials. So PAE should be monitored strictly, and provide scientific basis for rational use of antibacterial drugs for clinical anti-infection treatment.

关 键 词：铜绿假单胞菌 医院感染 抗药性 细菌 抗菌药 

分 类 号：R446.5[医药卫生—诊断学]