2010年宜昌市铜绿假单胞菌的耐药性分析

了解宜昌市铜绿假单胞菌（Pseudomonas aeruginosa）临床分离株的耐药现状。宜昌市城区5所医院临床分离的铜绿假单胞菌菌株,用K-B法作药敏试验,并根据统计其耐药情况及耐药表型（模式）分析可能存在的耐药机制。临床分离的铜绿假单胞菌共1 575株,耐药率依次为阿米卡星7.1%、美罗培南17.2%、头孢吡肟20.4%、头孢哌酮/舒巴坦21.0%、哌拉西林/他唑巴坦22.5%、环丙沙星23.1%、庆大霉素23.4%、头孢他啶25.0%、亚胺培南25.2%、哌拉西林30.4%、氨曲南34.5%、复方新诺明59.0%、米诺环素75.6%。多重耐药（MDR）和泛耐药（PDR）株分别占41.5%和0.17%。对各种抗假单胞菌药物分别耐药的菌株仍有13%～25.7%对阿米卡星敏感,提示在严重铜绿假单胞菌感染患者的治疗中,β内酰胺类抗假单胞菌药加氨基糖苷类仍是一个很好的联合用药组合。细菌耐药性仍呈增长趋势,临床上感染多重耐药和泛耐药的铜绿假单胞菌的治疗仍很棘手,应合理使用抗生素,尽量延缓耐药菌株的出现。

Analysis of Drug Resistance of Pseudomonas aeruginosa in Yichang City

The current drug resistant situation of clinically isolated strains of Pseudomonas aeruginosa(PA) from five big hospitals in Yichang was investigated using K-B methods as drug sensitive experiment.And analyze the possible existing drug resistance mechanism according to the statistics of their drug resistance situation and phenotype(pattern).The results showed that among 1 575 strains clinically isolated PA strains the drug resistance rate were successively as amikacin 7.1%,meropenem 17.2%,cefepime 20.4%,sulbactam/cefoperazone 21%,with piperacillin/tazobactam 22.5%,and ciprofloxacin 23.1%,gentamycin 23.4%,ceftazdime 25.0%,imipenem 25.2%,piperacillin 30.4%,zatreonam 34.5% sulphamethoxazole/trimethoprim 59.0%,minocycline 75.6%.Multiple drug resistance(MDR) and the pan-drug resistance(PDR) plants account for 41.5% and 0.17% respectively.For various kinds of Pseudomonas drug resistant strains are still 13%~25.7% of amikacin,suggested that sensitive serious PA is the treatment of patients with infection,the medicine of β lactamase and aminoglycoside is still a very good combination for PA.Drug resistance among bacteria is still a growing trend,clinical infection of MDR and PDR of PA is still a very thorny matter of treatment that remind medical workers to reasonably use of antibiotics,try to delay the emergence of resistant strains to the best.