摘要
目的：调查本院重症监护病房（ICU）内铜绿假单孢菌（PA）医院肺部感染情况及耐药性特点，为其防治提供依据。方法：对2004年6月-2005年12月ICU出院患者铜绿假单孢菌医院肺部感染病历进行回顾性分析，用微量稀释法测定13种抗菌药物对铜绿假单孢菌的MIC。结果：58例铜绿假单孢菌医院肺部感染占同期ICU医院肺部感染的24．3％。多发生于老年人，平均年龄（65±10）岁，多数有（2～4）种原发病和伴随病并存，所有患者均使用过抗菌药物，49例（84．5％）患者接受机械通气治疗，8例（13．8%）患者接受纤支镜诊断或治疗，45例（77．6％）患者住ICU时间≥2周，13种抗菌药物药敏结果显示亚胺培南、阿米卡星、哌拉西林-三唑巴坦及头孢吡肟的敏感率分剐为70．9％、56．9％、53．4％及50．0％，其他均〈50．0％。结论；ICU内铜绿假单孢菌医院肺部感染发生率高，具有多重耐药性，应该引起高度重视，特别是接受呼吸道侵入性操作患者，应注意各种医疗器械设备的消毒，早期的病原学检查及病原菌耐药性监测，并根据药敏结果选择如亚胺培南、阿米卡星、哌拉西林一三唑巴坦、头孢吡肟等敏感药物治疗。不宜选用环丙沙星、庆大霉素及头孢他啶等药物治疗。
Objective： To understand the clinical characteristics of nosocomial pulmonary infections caused by Pseudomonas aeruginosa （PA） and its drug resistance in ICU. Methods： The clinical data of 58 cases discharged from June 2004 to December 2005 were reviewed and analyzed. Minimum inhibitory concentration （MIC） of 13 antibiotics against PA was determined by microdilution method. Results： 24.3% of all pulmonary infections in ICU were nosocomial pulmonary infections caused by PA during the same period and it was accident in older patients （mean 65±10 years old）. These Patients usually had suffered from （2-4） kind of diseases and received previous antibiotic therapy. The susceptibility rate of Imipenem, Amikacin, Piperacillin-tazobactam and Cefepime was 70.7%, 56.9%, 53.4%, 50.0% respectively among the 13 antimicrobial agents tested. Conclusions： The nosoeomlal pulmonary infection of PA is easy in ICU, especially in patients who were performed respiratory tract invasive procedure. Our results suggest that Imipenem, Amikacin, Piperaeillin-tazobactam and Cefepime are of choice for treatment of PA infections. Ciprofloxacin, Gentamicin and Ceftazidine are appropriate for the treatment of infections caused by PA.
出处
《青海医药杂志》
2006年第11期9-11,共3页
Qinghai Medical Journal
关键词
铜绿假单孢菌
医院肺部感染
耐药性
重症监护室
Pseudomonas aeruginosa
Nosocomial pulmonary infection
Antimicrobial resistance
Intensive care unit
