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目的阐述铜绿假单胞菌(pseudomonas aeruginosa,PA)的医院感染途径与药物治疗方法。方法简述铜绿假单胞菌病原学概述;论述铜绿假单胞菌的临床感染类型、药物治疗方法及预防铜绿假单胞菌感染的措施。结果与结论铜绿假单胞菌临床感染类型分为菌血症、肺炎、烧伤和手术部位感染、脑膜炎、眼科术后感染和泌尿道感染。随着PA耐药率增加,且呈多重耐药,其趋势是:对碳青霉烯类仍最敏感,但敏感率已经下降甚至明显下降;头孢哌酮/舒巴坦钠和哌拉西林/三唑巴坦对PA显示较好抗菌活性;头孢他啶和头孢吡肟抗PA活性与碳青霉烯类相仿或略优;喹诺酮类对PA耐药率不断增加,而氨基糖苷类仍保留较好活性。在我国,因为头孢哌酮/舒巴坦钠和头孢他啶对PA的良好抗菌活性,在尚未威胁生命的中重度感染可以作为首选药物。
Objective To describe the nosocomial infection pathway and drug treatment of Pseudomonas aeruginosa (PA). Methods An overview of Pseudomonas aeruginosa etiology was summarized. The types of clinical infections, drug treatment and prevention of Pseudomonas aeruginosa infection were discussed. Results and Conclusion The clinical types of Pseudomonas aeruginosa were divided into bacteremia, pneumonia, burn and surgical site infection, meningitis, ophthalmology infection and urinary tract infection. With the increasing rate of PA resistance and multi-drug resistance, the trend is: the most sensitive to carbapenems, but the sensitivity rate has decreased or even decreased significantly; cefoperazone / sulbactam sodium and piperacillin / Tazobactam showed good antibacterial activity against PA; the antibacterial activity of ceftazidime and cefepime was similar to or slightly better than that of carbapenems; the quinolones resistance rate of PA was continuously increased, while aminoglycosides still retained good activity . In our country, because of cefoperazone / sulbactam sodium and ceftazidime good PA antibacterial activity, in the non-life-threatening moderate-severe infection can be used as the drug of choice.