中文摘要：

目的分析医院感染的铜绿假单胞菌（PAE）临床分布和药敏性,总结耐药现状和提出应对策略。方法对2011年1月-2012年12月医院住院患者送检的痰液、血液和分泌物等各类标本,应用美国BD-CTEC9120全自动血培养和法国VITEK-2Compact全自动细菌检定仪分析铜绿假单胞菌的耐药特点。结果 791株铜绿假单胞菌有63.0%来源于痰,主要分布于呼吸内科、ICU和神经内外科等科室;对氨基糖苷类中庆大霉素、妥布霉素的耐药率均较高,分别为65.9%、64.3%,阿米卡星较低为19.1%;对喹诺酮类药物较敏感,对环丙沙星、左氧氟沙星的耐药率分别为23.0%、18.1%,对第四代头孢吡肟耐药率为46.5%;对头孢他啶的耐药率达到了50.6%;对碳青霉烯类抗菌药物亚胺培南、美罗培南较为敏感,其耐药率分别为14.3%和12.9%,对哌拉西林/他唑巴坦的耐药率为13.4%。结论铜绿假单胞菌在医院表现出多药耐药和泛耐药;医院应重视抗菌药物的合理使用,加强耐药性监测和医院感染的防治;临床应结合药敏结果采用有效药物单一或联合、足量、足疗程治疗,以控制细菌耐药性的增长。

英文摘要：

OBJECTIVE To analyze the clinical distribution and drug susceptibility of Pseudomonas aeruginosa cau- sing nosocomial infections and put forward coping strategies. METHODS From Jan 2011 to Dec 2012, the sputum, blood, and secretions specimens were collected from the hospitalized patients, then the characteristics of drug re- sistance of the P. aeruginosa strains were analyzed by using BD-CTEC9120 automatic blood culture of USA and VITEK-2 Compact automatic bacterial identification analyzer of France. RESULTS Of the 791 strains of P. aeruginosa, 63.0 % were isolated from the sputum specimens, most of the strains distributed in the department of respir- atory medicine, ICU, and department of neurology. The strains were highly resistant to the aminoglycosides such as gentamicin and tobramycin, with the drug resistance rates of 65.9% and 64.3%, respectively; the drug resist- ance rate to amikacin was 19.10% ; the strains were susceptible to quinolones, and the drug resistance rates to cip- rofloxacin and levofloxaein were 23.0% and 18.1 %, respectively; the drug resistance rate to the fourth generation cefepime was 46.5% ; the drug resistance rate to ceftazidime reached up to 50.6% ; the strains were susceptible to carbapenems, and the drug resistance rates to imipenem and meropenem were 14.3% and 12.9%, respectively; the drug resistance rate to piperacillin-tazobactam was 13.4%. CONCLUSION The P. aeruginosa isolated in the hospital is characterized by multidrug-resistance or pandrug-resistance. It is necessary for the clinicians to pay high attention to the reasonable use of antibiotics, strengthen the surveillance of drug resistance and prevention of nosocomial infections, and perform the single or combination use of antibiotics for adequate and full treatment course therapy so as to control the growth of bacterial drug resistance.