目的 分析老年慢性疾病患者2010～2011年住院期间铜绿假单胞菌感染的临床分布和耐药性的变化情况.方法 临床送检的标本按卫生部检验操作规程进行分离,304株分离菌株应用GN48板条鉴定到种,并用MP板条和14种药敏纸片进行测定,对药敏结果通过LIS系统分析.结果 住院患者送检标本分离的304株铜绿假单胞菌均来自福州总医院第二住院部,其中老年康复科174株占57.24％、结核科48株占15.79％、放疗科26株占8.55％,其标本来源构成比为,呼吸道标本244株占80.26％,分泌物和其他标本为40株和20株各占13.16％和6.58％.铜绿假单胞菌对阿米卡星耐药率最高达84.21％,其它依次为氨曲南、庆大霉素和头孢吡肟,分别是78.94％,77.63％和75.00％,而哌拉西林/他唑巴坦、美罗培南和亚胺培南的耐药率较低≤20％.结论 老年慢性病患者的铜绿假单胞菌感染率较高,主要原因是由于老年人的机体抵抗力较弱,免疫力低下,不合理使用抗生素等,建议通过药敏试验合理地选择和使用抗菌药物,对遏制铜绿假单胞菌耐药率的攀升和提高治愈率有重要意义.%Objective Analysing the clinical distribution and resistance of Pseudomonas aeruginosa in elderly patients with chronic diseases from 2010 to 2011. Methods Clinical specimens were separated by the Ministry of Health Laboratory Procedures. 304 isolates were identified to species level using GN48 lath, susceptibilities to 14 antibiotics were determined by MP lath and LIS system. Results 304 Pseudomonas aeruginosa strains were isolated,including 174(57. 24%) from geriatric rehabilitation section,48(15. 79%) from tuberculosis and infection section and 26(8.55%) from radiotherapy section. 244 (80. 26%) were isolated from respiratory specimens, and 40(13. 16%) and 20(6. 58%) from secretions and other specimens. Up to 84. 21% of P seudomonas aeruginosa strains resist to amikacin,and 78. 94%, 77. 63% and 75. 00% resist to az-treonam, gentamicin and cephalosporin cefepime, while the piperacillin/tazobactam,meropenem and imipenem resistance rates were relatively low(≤20%). Conclusion Elderly patients infected with Pseudomonas aeruginosa rate high, mainly due to the weak immunity and the irrational usage of antibiotics. It is recommended to select antimicrobial agents through susceptibility testing,and it is important to curb the rising rate of Pseudomonas aeruginosa and improve the cure rate.
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