Raja Nadeem Sajjad, Singh Nishi Nihar
Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
J Microbiol Immunol Infect. 2007 Feb;40(1):45-9.
Pseudomonas aeruginosa is an important cause of morbidity and mortality in hospitalized, critically ill patients and patients with underlying medical conditions such as cystic fibrosis, neutropenia, and iatrogenic immunosuppression. The prevalence of multiresistant P. aeruginosa isolates has been increasing. The aim of this study was to determine the antimicrobial susceptibility patterns in P. aeruginosa strains isolated at a university teaching hospital in Kuala Lumpur, Malaysia.
The Laboratory Information System of the microbiology department was retrospectively reviewed to determine the susceptibility patterns of P. aeruginosa isolates to anti-pseudomonal antibiotics, from January to June 2005. Disk diffusion methods were employed and results were interpreted according to National Committee for Clinical Laboratory Standards guidelines.
505 clinical isolates of P. aeruginosa were tested. Major sources of these isolates included respiratory tract, wound, urine and blood. The rates of antimicrobial resistance of isolates were 6.73% to amikacin, 12.9% to gentamicin, 10.1% to netilmicin, 10.9% to ceftazidime, 11.3% to ciprofloxacin, 9.9% to imipenem, 10.8% to piperacillin, 9.4% to piperacillin-tazobactam and 0% to polymyxin B. Of the 505 isolates, 29 (5.74%) were found to be multidrug-resistant; these were most commonly isolated from respiratory tract specimens of patients in surgical units, followed by respiratory tract specimens in patients in medical units.
The data in this study showed low rates of antibiotic resistance among P. aeruginosa isolates. Combinations of aminoglycosides plus beta-lactams or quinolones should be the appropriate choice for empirical therapy in P. aeruginosa infections. Active antibiotic susceptibility testing and surveillance should be continued in order to curtail the problem of antibiotic resistance.
铜绿假单胞菌是住院重症患者以及患有潜在疾病（如囊性纤维化、中性粒细胞减少症和医源性免疫抑制）患者发病和死亡的重要原因。多重耐药铜绿假单胞菌分离株的患病率一直在上升。本研究的目的是确定在马来西亚吉隆坡一家大学教学医院分离出的铜绿假单胞菌菌株的抗菌药敏模式。
回顾性分析微生物学部门的实验室信息系统，以确定2005年1月至6月期间铜绿假单胞菌分离株对抗假单胞菌抗生素的药敏模式。采用纸片扩散法，并根据美国国家临床实验室标准委员会的指南对结果进行解释。
对505株铜绿假单胞菌临床分离株进行了检测。这些分离株的主要来源包括呼吸道、伤口、尿液和血液。分离株对阿米卡星的耐药率为6.73%，对庆大霉素为12.9%，对奈替米星为10.1%，对头孢他啶为10.9%，对环丙沙星为11.3%，对亚胺培南为9.9%，对哌拉西林为10.8%，对哌拉西林-他唑巴坦为9.4%，对多粘菌素B为0%。在505株分离株中，发现29株（5.74%）为多重耐药；这些分离株最常见于外科病房患者的呼吸道标本，其次是内科病房患者的呼吸道标本。
本研究数据显示铜绿假单胞菌分离株的抗生素耐药率较低。氨基糖苷类加β-内酰胺类或喹诺酮类联合应用应是铜绿假单胞菌感染经验性治疗的合适选择。应继续进行积极的抗生素药敏试验和监测，以减少抗生素耐药问题。
