315株铜绿假单胞菌医院感染的临床分布与耐药性分析  

Analysis of distribution and resistance of 315 strains Pseudomonas aeruginosa in clinical infection

作　　者：郑多金 林淑瑜[1] 殷超[1] 杨昌云[1] 

机构地区：[1]福建省泉州市解放军第180医院药学科,泉州市362000

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第1期59-62,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的了解本院铜绿假单胞菌耐药性及耐药特征,旨在指导临床合理使用抗菌药物。方法收集2013年临床分离的铜绿假单胞菌,采用生物梅里埃公司的ATBNEW系统进行细菌鉴定,用K-B法进行药物敏感性测定,结果严格按照美国CLSI的标准进行判读,并用WHONET 5.6软件分析细菌的耐药性。结果分离到的315株的铜绿假单胞菌中MDR-PA 98株,分布在神经外科、普外科、烧伤科共72株,占总数的73.47%,检出率为31.11%;PDR-PA 23株,检出率为7.30%。铜绿假单胞菌对头孢唑啉、呋喃妥因、头孢呋辛酯、头孢呋辛、复方新诺明和氨苄西林耐药率均为100%;MDR-PA耐药率较高的有亚胺培南(100%)、哌拉西林(72%)、庆大霉素(69%)和妥布霉素(69%);23株的PDR-PA对药敏试验药品的耐药率均达到了100%。铜绿假单胞菌对左氧沙星、环丙沙星、头孢吡肟、头孢他啶保持着较好的敏感性和抗菌活性。结论针对具体的耐药现状院内感染需采取必要的防控措施,尽可能减少或延缓泛耐药菌的产生和流行传播。Objective To investigate the distribution and resistance of climical isolates of Pseudomonas aeruginosa, and guide reasonable using of antibiotics in clinic. Methods Total of 315 Pseudomonas aeruginosa climical isolates from January 2013 to December 2013. The bacteria identiifcation were analyzed by bioMerieux＇s ATBNEW system and WHONET 5.6 software. The drug sensitivity were determined by K-B method and the results were analyzed in strict accordance with the standards of the American CLSI. Results There were 98 strains of multi-drug resistant Pseudomonas aeruginosa （MDR-PA） among the 315 strains of Pseudomonas aeruginosa were isolated, the detection rate of MDR-PA was 31.11%. There were 72 strains MDR-PA mainly scattered in neurosurgery and general surgery which accounted for 73.47%（98 strains）. PDR-PA were 23 strains, the detection rate of PDR-PA was 7.30%. Drug sensitive tests showed that Pseudomonas aeruginosa was highly resistant to most of the commonly used antibiotics such as cefazolin, nitrofurantoin, cefuroxime axetil, cefuroxime, cotrimoxazole and ampicillin, the resistance rates were all 100%. MDR-PA had higher rates of resistance to imipenem （100%）, piperacillin （72%）, gentamicin （69%） and tobramycin （69%）. There were 21 kinds drugs of susceptibility testing for 23 strain PDR-PA and the resistance rates were all 100%. Pseudomonas aeruginosa maintained high sensitivity and antibacterial activity to levofloxacin, ciprofloxacin, cefepime and ceftazidime. Conclusions It urgently need take the necessary control measures for the current situation of antibiotics resistance and as far as possible to reduce or delay the spread and popular of PDR-PA.

关 键 词：铜绿假单胞菌 临床分布 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]