摘要
目的分析铜绿假单胞菌(PAE)临床株对常用抗菌药物的耐药性变化,为临床医师选择敏感药物有效进行抗感染治疗提供实验室参考依据。方法回顾性调查分析医院2010-2012年475株PAE在各类标本中的分布及对常用抗菌药物的耐药率;PAE分离培养、鉴定严格按照WHO规定的临床微生物学操作标准进行;药敏试验和结果评价采用WHO及CLSI推荐的K-B法进行;数据处理采用WHONET5.5软件分析。结果 3年培养出的475株PAE高检出部位主要是:呼吸道241例占50.7%、泌尿道103例占21.7%、手术切口及创伤分泌物47例占9.9%等;3年PAE对大多数抗菌药物的耐药率呈逐年上升趋势,医院耐亚胺培南PAE 3年耐药率分别为7.2%、9.6%、14.1%;耐药率最高的药物是磺胺甲噁唑/甲氧苄啶,均>66.0%;耐药率>40.0%的抗菌药物有头孢噻肟、环丙沙星、哌拉西林和庆大霉素;耐药率<15.0%的抗菌药物有阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦。结论医院临床流行的PAE对常用抗菌药物的耐药率逐年增长,动态监测PAE的耐药性变迁,强制性管理抗菌药物应用,对临床针对性治疗感染性疾病与延缓多药耐药菌的发生具有十分重要的意义。
OBJECTIVE To analyze the evolution of antimicrobial resistance in clinical isolates of Pseudornonas aeruginosa （PAE） in my hospital, so as to provide the experimental reference for rationally clinical use of antibiot- ics and effective anti-infective treatment. METHODS A retrospective analysis about the distribution constituent ratio of 475 PAE in the various samples, and the resistance rate of common antibiotics were performed from 2010 to 2012. Bacterial isolation, culturation and identification were performed according to standard microbiological procedures issued by WHO. The susceptibility testing and results judgement were carried out by K-B methods recommended by WHO and CLSL WHONET 5.5 software was ued to adopt the date. RESULTS The 475 PAE strains isolated in three years were mostly from respiratory tract （241, 50.7%）, urinary tract （103, 21.7%） and operative incision and wound secretion （47, 9.9%）. The drug resistance rates of most antibiotics against PAE in three years were rising gradually. Detection rates of imipenem-resistant PAE in three years were 7.2 %, 9.6 % and 14.1%, respectively. Antibiotics with the highest resistance rate was trimethoprim/sulfamethoxazole （%66 %）. Antibiotics with more than 40% of resistance rate included cefotaxime, ciprofloxacin, piperacillin and gentamycin. Those with less than 15 % of resistance rates were amikacin, imipenem, meropenem, cefoperazone/sulbactam and piperacillin/tazobactam. CONCLUSION Resistance rates of commonly used antibiotics against PAE have generally increasing tendency during three years. Dynamic monitoring of evolution of antimicrobial resistance of PAE and mandatory management of antibiotics are very important for the clinical treatment of infective diseases and postpo- ning the occurrence of multi-resistant strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第8期1840-1842,共3页
Chinese Journal of Nosocomiology
基金
湖北省卫生厅基金项目(WJ01564)
关键词
铜绿假单胞菌
耐药性
监测
变迁
Pseudomonas aeruginosa
Resistance
Monitoring
Evolution
