摘要
目的探讨多重耐药铜绿假单胞菌临床分布及耐药性情况。方法收集2014年1月～2015年4月长兴县中医院重症监护室248例患者铜绿假单胞菌临床标本，采用培养鉴定和药敏试验进行检测。结果分离铜绿假单胞菌210株，其中，多重耐药菌60株，多重耐药菌检出率为28．6％。60株多重耐药铜绿假单胞菌主要分布在痰液（40株，66．7％），其次为伤口分泌物（11株，18．3％）、尿液（9株，15．0％）。耐药情况分析结果显示，头孢他啶（41．7％）、头孢吡肟（38．3％）、哌拉西林（48．3％）、替卡西林（58_3％）、哌拉西林他唑巴坦（58．3％）、替卡西林，克拉维酸（58．3％）、氨苄西林／舒巴坦（100．0％），耐药率均较高；氨曲南（33．3％）、亚胺培南（30．0％）、美罗培南（30．0％）、庆大霉素（40．0％）、阿米卡星（26．7％）、环丙沙星（33．3％）、左氧氟沙星（33．3％），耐药率均较低。检出10株泛耐药菌株，检出率为16．7％，通过补充药敏实验，6株（60．0％）对头孢哌酮，舒巴坦耐药，对于多黏菌素B无耐药发生。结论对于多重耐药铜绿假单胞菌可以采用青霉烯类、喹诺酮类联合用药治疗，对于泛耐药菌株可以应用多黏菌素B进行治疗。
Objective To discuss the clinical distribution of muhiple drug resistant pseudomonas aeruginosa and its drug resistance. Methods Clinical specimens of pseudomonas aeruginosa from 248 patients in ICU of Hospital of Tra- ditional Chinese Medicine of Changxing County from January 2014 to April 2015 were selected, which were detected by culture identification and drug sensitive test. Results There were 210 plants of pseudomonas aeruginosa separated, 60 plants had multiple drug resistance, the detection rate was 28.6%. 60 plants of multiple drug resistant pseudomonas aeruginosa mainly distributed in sputum （40 cases, 66.7%）, following by wound secretion （11 cases, 18.3%）, urine （9 cases, 15.0%）. Drug resistance results analysis showed that the drug resistance rates of Ceftazidime （41.7%）, Cefepime 38.3% 58.3% 30.0% Piperacillin （48.3%）, Ticarcillin （58.3%）, Piperacillin/Tazobactam （58.3%）, Ticarcillin/Clavulanic Acid Ampicillin/Sulbactam （100.0%） were higher; the drug resistance rates of Aztreonam （33.3%）, Imipenem Meropenem （30.0%）, Gentamicin （40.0%）, Amikacin （26.7%）, Ciprofloxacin （33.3%）, Levofloxacin （33.3%） were lower. There were 10 plants of generic drug resistant strains, the detection rate was 16.7%; through complementary medicine sensitive experiment, there were 6 plants （60.0%） had drug resistance to Cefoperazone/Sulbactam, there was no drug resistance to Polymyxin B. Conclusion The penicillium alkene, quinolones combination therapy can be used for multiple drug resistant pseudomonas aeruginosa treatment, generic drug resistant strains should be given Polymyxin B treatment.
出处
《中国医药导报》
CAS
2016年第4期121-124,共4页
China Medical Herald
关键词
多重耐药铜绿假单胞菌
临床分布
耐药性
Multiple drug resistant pseudomonas aeruginosa
Clinical distribution
Drug resistance
