다약제 내성 녹농균의 유행과 항균제 감수성

Abstract

Pseudomonas aeruginosa is one of the leading causes of nosocomial infections. The increasing frequency of multidrug resistant Pseudomonas aeruginosa (MDRPA) strains is concerning as efficacious antimicrobial choices are severely limited. A total of 125 strains of Pseudomonas aeruginosa isolated from various clinical specimens in Daegu area were tested for antimicrobial drug susceptibility to 28 drugs including polymyxin B, colistin, cefepime, meropenem and levofloxacin. Pseudomonas aeruginosa were most frequently isolated from sputum (49.6%), and followed by urine (22.4%), wound discharge (11.2%) and etc. All the strains were susceptible to polymyxin B and colistin. The resistance frequencies of piperacillin, cefepime, aztreonam and imipenem were 32.0-36.8%. The resistance frequencies of carbenicillin, ticarcillin, ceftazidime, ceftriaxone, meropenem, netilmicin, tobramycin, norfloxacin, ofloxacin and levofloxacin were 42.4-61.6%. Most of strains were resistant to cefoperazone, cefotaxime, moxalactam, ceftizoxime, amikacin, gentamicin, ciprofloxacin and moxifloxacin, and all the strains were resistant to rifampin and tetracycline. MIC90 of aztreonam, imipenem, ciprofloxacin and rifampin were 64 μg/mL, and those of piperacillin, ceftazidime, norfloxacin and tetracycline were 128-256 μg/mL. MIC90 of the rest of the drugs were more than 1024 μg/mL. Isolation frequency of MDRPA strains was 82.4% (103 strains) and was highly prevalent. Twenty five (20.0%) strains were multiply resistant to 21 drugs and 71 (56.8%) strains were multiply resistant to more than 11 drugs. Continued surveillance of MDRPA prevalence and antimicrobial resistance patterns should provide information that is important to choose effective drugs for MDRPA infections.