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目的:分析临床铜绿假单胞菌感染的药敏变化,比较ICU与非ICU铜绿假单胞菌的耐药性,为临床合理使用抗菌药物提供参考。方法:选取2013年1月—2014年12月间临床各类标本中分离的544株铜绿假单胞菌(剔除同一患者7 d内重复分离的菌株),其中ICU 237株与非ICU 307株;铜绿假单胞菌的培养鉴定严格按照原卫生部制定的《临床微生物检验操作规范》要求;药敏试验采用K-B纸片法,用SPSS 19.0版统计学软件分析临床分离细菌的药敏试验结果。结果:ICU和非ICU铜绿假单胞菌对环丙沙星、亚胺培南、左氧氟沙星、美洛培南和哌拉西林的耐药率分别为46.99%,67.93%,59.49%,56.12%,42.62%和14.33%,20.20%,25.08%,8.79%,22.15%;ICU铜绿假单胞菌感染的耐药率明显高于非ICU(P<0.05)。结论:ICU铜绿假单胞菌的耐药率高于ICU,在临床选用抗菌药物治疗铜绿假单胞菌感染时应根据当地细菌耐药特点,合理选用抗菌药物,以防止多重耐药铜绿假单胞菌甚至是泛耐药菌株的传播与感染。
OBJECTIVE: To analyze the change of drug sensitivity of clinical Pseudomonas aeruginosa infection and to compare the drug resistance of Pseudomonas aeruginosa and non-ICU in ICU, so as to provide a reference for the rational use of antimicrobial agents. Methods: 544 strains of Pseudomonas aeruginosa isolated from clinical specimens from January 2013 to December 2014 were selected, and 237 strains of ICU and 307 strains of non - ICU were selected. Pseudomonas aeruginosa culture identification in strict accordance with the original Ministry of Health, “Clinical Microbiology Test Code” requirements; susceptibility testing using KB paper method, using SPSS 19.0 statistical software analysis of clinical isolates of bacteria susceptibility test results. Results: The rates of resistance to ciprofloxacin, imipenem, levofloxacin, meropenem and piperacillin in ICU and non-ICU were 46.99%, 67.93%, 59.49% and 56.12%, respectively. 42.62% and 14.33%, 20.20%, 25.08%, 8.79% and 22.15% respectively. The drug resistance rate of ICU-infected Pseudomonas aeruginosa was significantly higher than that of non-ICU (P <0.05). Conclusion: The drug resistance rate of Pseudomonas aeruginosa in ICU is higher than that of ICU. In the clinical use of antibacterial drugs for the treatment of Pseudomonas aeruginosa infection, the antibacterial drugs should be selected reasonably according to the characteristics of local bacteria resistance to prevent the multi-drug resistant Pseudomonas aeruginosa The spread and infection of cell strains and even pan-resistant strains.