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目的了解院内与院外不同环境样本中分离的铜绿假单胞菌(PA)对常用抗生素的变化,掌握PA菌株药物敏感性的分布与流行趋势,比较相互间差异,探讨医疗环境中PA菌的耐药性是否与其生存环境有关联性,为疾病预防控制工作及临床用药提供参考。方法收集2007年至2009年日常医疗机构监测样品及食品饮用水样品中分离到的铜绿假单胞菌,采用法国生物梅里埃公司生产VITEK 2仪进行细菌鉴定及药敏试验。结果 43株PA菌对阿米卡星、妥布霉素、环丙沙星的敏感率为85.0%;对庆大霉素、左旋氧氟沙星的敏感率为80.0%;对美洛培南的敏感率为75.0%;对亚胺培南的敏感率为70.0%;对氨苄西林、氨苄西林/舒巴坦等14种抗菌素的敏感率为0;其中有院内环境分离的4株PA菌对21种抗菌素的敏感率为0。结论院内医疗环境分离的PA菌株比院外环境分离到的PA菌株的药物敏感性普遍要低,院内医疗环境分离的部分PA菌株对常用的21种抗生素有完全的耐药作用,应该引起疾病预防工作者及临床医护工作者的高度重视。
OBJECTIVE To understand the changes of commonly used antibiotics isolated from Pseudomonas aeruginosa (PA) in different environmental samples both in and out of hospital and to find out the distribution and trend of drug susceptibility of PA strains. To compare the differences between PA strains in medical environments Whether the drug is related to its living environment or not, and provide a reference for disease prevention and control work and clinical medication. Methods Pseudomonas aeruginosa isolated from monitoring samples and drinking water samples from 2007 to 2009 were collected. Bacterial identification and drug susceptibility tests were performed using the VITEK 2 instrument manufactured by Merlot France. Results The sensitivity of 43 strains of PA to amikacin, tobramycin and ciprofloxacin was 85.0%, the sensitivity to gentamicin and levofloxacin was 80.0%, and the sensitivity to meropenem Sensitive rate was 75.0%; sensitive rate to imipenem was 70.0%; sensitive rate to ampicillin, ampicillin / sulbactam and other 14 antibiotics was 0; among them there were 4 PA isolates The sensitivity of 21 antibiotics was zero. CONCLUSIONS: PA isolates isolated from the hospital environment are generally less susceptible than PA isolates isolated from the hospital environment. Some PA isolates isolated from the hospital medical environment are fully resistant to the commonly used 21 antibiotics and should cause disease prevention And clinicians attach great importance to workers.