126株铜绿假单胞菌的临床分布及耐药性分析

目的调查分析象山县中医医院铜绿假单胞菌的临床分布及药敏情况，为临床合理选用抗生素提供可靠的依据。方法采集疑似患者的标本，进行分离、培养与鉴定。采用自动微生物鉴定／药敏分析仪进行鉴定及药敏试验，对2012年7月至2013年10月分离出的126株铜绿假单胞菌（包括21株黏液型铜绿假单胞菌）的分布及耐药性进行回顾性分析。结果126株铜绿假单胞菌临床主要分布情况：痰占80．2％，尿液占11．1％，脓液占7．1％，以呼吸道感染为主。对铜绿假单胞菌保持活性较强同时耐药率〈20％的抗生素有阿米卡星、妥布霉素、亚胺培南、哌拉西林／他唑巴坦，其中碳青霉烯类耐药率升至5％，原来被认为抗铜绿假单胞菌较为有效的喹诺酮类抗生素的耐药率也有了很大提升，左氧氟沙星耐药率升至33％。黏液型铜绿假单胞菌的体外抗菌药物敏感试验耐药性较弱，且明显弱于非黏液型铜绿假单胞菌的耐药性。结论铜绿假单胞菌为医院呼吸道感染的常见致病菌，对多种抗菌药物呈不同程度耐药。加强动态监测，合理使用抗菌药物，对铜绿假单胞菌感染的预防和药物治疗具有重要指导意义。

Clinical distribution and drug resistance of 126 strains of Pseudomonas aeruginosa

Objective To investigate and analyze the clinical distribution and drug resistance of Pseudomonas aeruginosa in our hospital, so as to provide basis for reasonable selection of antibiotics in clinical practice. Methods Clinical specimens of suspected patients were collected for bacterial isolation and identification. A retro- spective analysis on the distribution and drug resistance of 126 strains of Pseudomonas aeraginosa, isolated from Ju- ly 2012 to October 2013, was performed by using automatic bacteriology identification/drug sensitivity analyzer. Results The 126 strains of Pseudomonas aeruginosa mainly came from sputum （ 80.2% ） , urine （ 11. 1% ） and pus （7.1% ）. The resistance rates of Pseudomonas aeruginosa to Amikacin, tobramycin, imipenem, and piperacil- lin/tazobactam were lower than 20%. The resistance rate to carbapenem increased to 5%, while that to quinolones also increased significantly and that to levofloxacin had increased up to 33%. In vitro, the resistance of mucoid Pseudomonas aeruginosa was low, and much lower than that of non-mucoid Pseudomonas aeruginosa. Conclusion Pseudomonas aeruginosa is a common pathogen that can cause nosocomial respiratory tract infection and shows multiple antibiotic resistance. To strengthen the dynamic monitoring and rational use of antimicrobial drugs has an important guiding significance for prevention and treatment of Pseudomonas aeruginosa infections.