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目的探讨临床分离铜绿假单胞菌(PAE)耐药性变迁及其防治。方法对河南大学准河医院2000-2007年临床分离菌株K-B法药敏试验结果进行分析。结果629株PAE占总菌株数的13.8%,居首位。PAE对环丙沙星等13种临床常用抗菌药物耐药率均呈增高趋势;对哌拉西林等5种药耐药率变化类型相似,近三年看属上升趋势;对头孢曲松73.0%的耐药率保持相对稳定;对多粘菌素等4种药耐药率均有下降。PAE对头孢噻肟等8种药耐药率高达75.0%～100%,对9种药物较敏感依次为:多粘菌素、亚胺培南、环丙沙星、头孢吡肟、头孢他啶、哌拉西林/他唑巴坦、阿米卡星、左氧氟沙星、头孢哌酮,总耐药率均<30%。结论PAE是医院感染最常见致病菌,耐药性很强。PAE感染可依据药敏结合临床选用头孢他啶、环丙沙星等抗菌活性强的药物,对PAE严重感染可选亚胺培南或采取β-内酰胺类与阿米卡星或左氧氟沙星联合用药方案。
Objective To investigate the change of clinical isolates of Pseudomonas aeruginosa (PAE) and its prevention and cure. Methods The results of susceptibility testing of clinical isolates K-B from 2000 to 2007 in Zhunhe Hospital of Henan University were analyzed. Results 629 PAEs accounted for 13.8% of the total number of strains, ranking the first place. The resistance rates of PAE to thirteen kinds of commonly used antimicrobial agents such as ciprofloxacin tended to increase. The types of resistance to five drugs such as piperacillin were similar and showed an upward trend in recent three years. Resistance rate remained relatively stable; resistance to polymyxin and other four drugs have decreased. PAE cefotaxime and other 8 kinds of drug resistance rates as high as 75.0% to 100%, 9 drugs were sensitive to polymyxin, imipenem, ciprofloxacin, cefepime, ceftazidime, piperazine Lacyillin / tazobactam, amikacin, levofloxacin, cefoperazone, the total resistance rate was <30%. Conclusion PAE is the most common pathogen of nosocomial infection and is highly resistant. PAE infection can be based on drug sensitivity combined with clinical use of ceftazidime, ciprofloxacin and other drugs with strong antibacterial activity, serious infection with PAE optional imipenem or to take β-lactam and amikacin or levofloxacin combination regimen.