摘要
目的探讨综合性ICU铜绿假单胞菌(PA)引发的医院内感染临床及其药敏特点.方法对温州医学院附属第一医院ICU 1997～2002年铜绿假单胞菌医院感染进行回顾性分析.用16种常用抗生素进行体外药敏试验,采用Kirby-Bauer纸片扩散法按NCCLS标准进行.结果根据感染部位,PA引发的感染常见于下呼吸道(87.64%)、尿路(7.87%)及皮肤(4.49%).患者基础疾患包括神经系统疾病(43.82%),COPD(12.36%),各种恶性肿瘤(8.99%),以及各种创伤和大手术后等.体外药物敏感率从高到低依次为头孢哌酮-舒巴坦(84.85%),头孢他啶(80%),妥布霉素(78.46%),庆大霉素(67.5%),亚胺培南(56.72%),奈替米星(55.74%),培氟沙星(45.33%),替卡西林(38.60%),其它头孢3代的敏感率均较低.结论综合性ICU内PA引起的机会感染率高,在临床上应在药敏指导下用药,经验性治疗则优先考虑选用头孢哌酮-舒巴坦、头孢他啶、氨基糖甙类和亚胺培南等敏感性较高的抗生素,同时注意防止是交叉感染,积极治疗原发病.
Objective To investigate the clinical and drug sensitivity analysis of Pseudomonas aeruginosa （PA） in IUC. Drug sensitivity tests were made for 16 antimicrobial agents and conducted by K-B paper method according to the standard made by NCCLS. Methods A retrospective investigation was made for PA of nosocomial infection from January 1997 to March 2002 in ICU of our hosptal. Results The mainly infection position was respitatory （87.64%）,the next were urinary （7.87%） and skin （4.49%）. The underlying diseases of the patients included nerve system disease （43. 82%）, chronic obstructive pulmonary disease （12. 36%）, malignant tumor （8.99 % ）, injurity and after operations. Drug sensitivity rate of Cefoperazone-Sulbactam was 84. 85 %, Ceftazidime 80% ,Tobramycin 78.46% ,Gentamycin 67.5% ,Imipenem 56.72% ,Netilmcin 55.74% ,Pefloxacin 45.33% ,Ticarcillin 38.60%. The drug sensitivity rate of the other third generation cephalosporius were low. Conclusions The infection rate of PA in ICU was high. Antimicrobial treatment with PA infection shoud be guided by drug sensitivity test. While the first choice for experimental treatment is Cefoperazone-Sulbactam,Ceftazidime,Aminoglycoside or Imipenem. At the same time,we must avoid across infection and treat the primary diseases activly.
出处
《中国微生态学杂志》
CAS
CSCD
2005年第5期372-373,共2页
Chinese Journal of Microecology
关键词
铜绿假单胞菌
抗生素
敏感性
医院感染
Psudomonas aeruginosa
Antimicrobial agents
Drug sensitivity
Nosocomial infection
