[1]杨政,袁喆,李崇智,等.2009-2011年重庆某三甲医院铜绿假单胞菌耐药性分析[J].陆军军医大学学报(原第三军医大学学报),2012,34(21):2191-2194.
　Yang Zheng,Yuan Zhe,Li Chongzhi,et al.Resistance surveillance of Pseudomonas aeruginosa in a chongqing Grade AAA hospital from 2009 to 2011[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(21):2191-2194.
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陆军军医大学学报（原第三军医大学学报）[ISSN:1000-5404/CN:51-1095/R]

卷:
34卷
期数:
2012年第21期
页码:
2191-2194
栏目:
论著
出版日期:
2012-11-15

文章信息/Info

Title:
Resistance surveillance of Pseudomonas aeruginosa in a chongqing Grade AAA hospital from 2009 to 2011
作者:
杨政; 袁喆; 李崇智; 任玉涵
重庆医科大学附属第一医院感染科，重庆市传染病寄生虫病学重点实验室
Author(s):
Yang Zheng;  Yuan Zhe;  Li Chongzhi;  Ren Yuhan
Key Laboratory of Infectious and Parasitic Diseases in Chongqing，Department of Infectious Diseases, First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
关键词:
铜绿假单胞菌; 耐药性; 多重耐药; 重症监护室
Keywords:
Pseudomonas aeruginosa;  antibiotic resistance;  multi-drug-resistant;  intensive care units
分类号:
R378.99+1；R181.35；R915
文献标志码:
A
摘要:
目的      分析重庆医科大学附属第一医院2009年1月至2011年12月分离的铜绿假单胞菌对抗菌药物的耐药性，为临床合理治疗提供依据。      方法        采用纸片扩散法，以CLSI2010年标准判断临床分离株的敏感性，分析采用WHONET5.4及SPSS 18.0统计软件。      结果        3年来共分离出铜绿假单胞菌853株，其中多重耐药铜绿假单胞菌165株，占19.3%。2011年较2009年，分离出的铜绿假单胞菌对阿米卡星、头孢他啶、头孢哌酮、环丙沙星的耐药率分别由17.8%、25.8%、77.9%、28.2%下降至11.9%、12.8%、25.9%、23.1%；对亚胺培南、β-内酰胺酶抑制剂复合物的耐药率分别由2009年的14.7%、5.3%～11.7%上升至2011年的22.5%、12.2%～14.4%。ICU多重耐药铜绿假单胞菌的检出率明显高于非ICU，且其在ICU与非ICU的检出率均有下降。多重耐药铜绿假单胞菌对头孢他啶、头孢吡肟、头孢哌酮耐药率分别由2009年的61.9%、57.1%、100%下降至2011年的39.0%、51.2%、70.7%；对亚胺培南、β-内酰胺酶抑制剂复合物的耐药率分别从2009年的33.3%、33.3%～35.7%上升至2011年的58.5%、43.9%～46.3%。      结论       该三甲医院多重耐药铜绿假单胞菌对亚胺培南和β-内酰胺酶抑制剂复合物的耐药率，2011年较2009年明显上升，加强细菌耐药性监测和抗菌药物分级管理，以利于指导临床合理使用抗菌药物及减少和控制细菌耐药的发生。
Abstract:
Objective      To investigate the drug resistance of clinical isolates of P. aeruginosa from Jan. 2009 to Dec. 2011, and provide a reference for clinical treatment.       Methods         Disk diffusion test was used to study the antimicrobial susceptibility. Results were evaluated on the basis of CLSI 2010. WHONET 5.4 and SPSS l 8.0 were used to analyze the data.       Results        During the past 3 years, 835 strains of P. aeruginosa were separated from all kinds of clinical samples, including 165 strains of multiple drug-resistant P. aeruginosa, which accounted for 19.3%. The resistance rates of the isolated strains of P. aeruginosa to amikacin, ceftazidime, cefoperazone, ciprofloxacin was decreased from 17.8%, 25.8%, 77.9%, and 28.2% in 2009 to 11.9%, 12.8%, 25.9%, and 23.1% in 2011, respectively. And its resistance rates to imipenem, beta-lactamase inhibitors composite was increased from 14.7%, 5.3% to 11.7% in 2009 to 22.5%, 12.2% to 14.4% in 2011. The detection rate of multiple drug-resistant P. aeruginosa in the ICU was found significantly higher than that in the non-ICU, and the isolated strains of multiple drug-resistant P. aeruginosa, both from ICU and non-ICU, their detection rates were decreased. Compared with the resistance rates of multiple drug-resistant P. aeruginosa to ceftazidime, cefepime and cefoperazone in 2009, the resistance rates in 2011 were reduced from 61.9%, 57.1%, and 100% to 39.0%, 51.2%, and 70.7%, respectively. And the resistance rates to imipenem, beta-lactamase inhibitors composite in 2011 rose from 33.3%, 33.3% to 35.7% in 2009 to 58.5%, 43.9% to 46.3%, respectively.       Conclusion      The resistance rates of drug-resistant P. aeruginosa in our hospital to imipenem and beta-lactamase inhibitors composite are significantly higher in 2011 than in 2009. The monitoring of antibiotic resistance and the management of antibactics grading system should be strengthened, so as to help guide the rational use of antimicrobials clinically, reduce and control the occurrence of bacterial resistance.

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更新日期/Last Update: 2012-11-06