十堰地区铜绿假单胞菌流行趋势及耐药性变迁

目的调查十堰地区某教学医院铜绿假单胞菌流行趋势和耐药变化趋势，为指导临床合理使用抗菌药物提供参考。方法运用WHONTE5．5软件分析2001-2011年2839株医院感染铜绿假单胞菌的药敏结果。Cox．Staurt趋势检验分析医院感染铜绿假单胞菌检出率和耐药趋势。结果2001-2011年铜绿假单胞菌的检出率呈上升的趋势，常见分离标本为痰和外伤分泌物。铜绿假单胞菌仅对头孢哌酮／舒巴坦和亚胺培南的耐药率小于30％．对其他抗菌药物的耐药率均较高。Cox-Staurt趋势检验分析显示，医院感染铜绿假单胞菌对头孢噻肟、头孢他啶、氨曲南、阿米卡星、庆大霉素、环丙沙星、亚胺培南和哌拉西林耐药率呈上升趋势（P〈0．05），而对复方新诺明、氯霉素和头孢哌酮／舒巴坦耐药率未见升高趋势。结论铜绿假单胞菌引起的医院感染越来越严重，其临床分离率高，且对多种药物的耐药率呈上升趋势，应加强细菌耐药性监测和抗菌谱分析，以控制耐药菌株。

Prevalence of Pseudomonas aeruginosa and the pattern of their drug resistance in Shiyan area

Objective To investigate the pattern of the drug resistance and the prevalence of Pseudomonas aeruginaosa in a teaching hospital, and to provide the scientific basis for rational administration of antibacterial drugs. Methods WHONTE 5.5 software was used to analyse the results of susceptibility test obtained between 2001 and 2011. Drug resistance was analyzed by Cox-Staurt trend test. Results There was a tendency in the increase in the isolation of Pseudomonas aeruginaosa from the samples of sputum and wound secretions. Less than 30% of the isolates were resistant to Cefoperazone-sulbactam. Over 40% of the isolates were resistant to other antibiotics. According to the results of Cox- Staurt trend test, there was an increase in the resistant rate to Cefotaxime,ceftazidime,aztreonam,Amikacin, gentamicin, ciprofloxacin, imipenem and piperacillin. Resistant to Sulfamethoxazole and Cefoperazone/sulbactam was not found. Conclusion Nosocomial infection with Pseudomonas aeruginosa was high. There was a tendency in the increase in drug resistance. We should strengthen the surveillance of antimicrobial resistance and antimicrobial spectrum analysis, in order to control the development of resistant strains.