铜绿假单胞菌耐药动态监测.doc

铜绿假单胞菌耐药动态监测[摘要] 目的：调查2002年、2005年本院铜绿假单胞菌对临床常用抗菌药物的耐药情况及动态变化，。方法：应用美国德灵公司Oade Microscan Autoscan-4自动分析系统进行菌株鉴定和药物敏感性测试。采用X2检验，比较2005年与2002年铜绿假单胞菌对临床常用抗菌药物的耐药率变化是否具有统计学意义。结果：2005年1月至2005年12月分离出148株铜绿假单胞菌临床分离株，其耐药率依次为头孢曲松85.6%，派拉西林75.4%，头孢噻肟73.9%，派拉西林/他唑巴坦68.5%，头孢他啶65.7%，氨曲南63.9%，头孢呋肟40.0%，庆大霉素35.5%，妥布霉素31.9%，头孢吡肟31.2%，环丙沙星28.2%，阿米卡星19.1%，亚胺培南18.2%。与2002年（86株）比较，哌拉西林（29.1%），哌拉西林/他唑巴坦（23.3%）、氨曲南（30.6%）、头孢他啶（36.5%）耐药率明显升高（P＜0.01）；环丙沙星（45.1%）耐药率明显下降（P＜0.01）；亚胺培南（15.1%），阿米卡星（22.1%），妥布霉素（39.5%）耐药率无明显变化（P＞0.05）。结论：铜绿假单胞菌仅对碳青霉烯类，氨基糖苷类，氟喹诺酮类，第四代头孢菌素保持较高敏感性。铜绿假单胞菌对派拉西林，哌拉西林/他唑巴坦，氨曲南，头孢他啶敏感性明显下降；对环丙沙星敏感性明显提高。[关键词] 铜绿假单胞菌； 药物敏感性测定； 微生物； 耐药Epidemiology of aitimicrobial resistance of pseudomonas aeruginosa in a university hospitalWen guilan, Meng junping, Zhu zirong, Liu qin, Zeng qinghua.(Respiratory department, 1thaffiliated hospital of Nanchang university, Nanchang330006, China)[Abstract] Objective: To investigate the in vitro activity of imipenem, amikacin, piperacillin, piperacillin/tazobactam, ciprofloxacin, aztreonam, ceftazidime, cefotrixone, cefotaxime, cefopime, gentamicin, tobramicin against pseudomonas aeruginosa isolated in 2002 and 2005 as well as compare their variance. Methods: The MICs of those antibiotics against 148 strains of pseudomonas aeruginosa were tested by broth microdilution method according to the approved standard of NCCLS. Results: The resistant rates of pseudomonas aeruginosa isolated in 2005 to cefotrixone, piperacillin, cefotaxime, piperacillin/tazobactam, ceftazidine, aztreonam, gentamicin, tobramicin, cefopime, ciprofloxacin, amikacin, imipenem were85.6%, 75.4%, 73.9%, 68.5%, 65.7%, 63.9%, 35.5%, 31.9%, 31.2%, 28.2%, 19.1%, 18.2% respectively. Compared with the resistant rates of pseudomonas aeruginosa isolated in 2002, the resistant rates of pseudomonas aeruginosa in 2005 to piperacillin, piperacillin/tazobactam, ceftazidime increase remarkably ，their resistant rates being29.1%, 1作者单位：1.330006 南昌 南昌大学第一附属医院呼吸科2.南昌大学医学院研究生23.3%, 30.6%,