医院感染非发酵革兰阴性杆菌的分布与耐药性分析

    Distribution and drug resistance of clinical common non-fermentative gram-negative bacilli

    • 摘要: 目的:了解医院感染非发酵革兰阴性(G-)杆菌的临床分布特点及耐药性,为临床合理使用抗生素提供依据。方法:将各类临床标本中分离的728株非发酵G-杆菌进行统计和耐药性分析,细菌鉴定和药敏分析采用纸片琼脂扩散法和最小抑菌浓度法,按美国临床实验室标准化委员会制定的标准判断。结果:728株非发酵G-杆菌中,居前4位的依次为鲍曼不动杆菌330株,铜绿假单胞菌290株,嗜麦芽窄食单胞菌38株,洋葱伯克霍尔德菌38株。分布在呼吸系统为543株,以重症监护治疗病房最多,共308株。铜绿假单胞菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率低于30%;鲍曼不动杆菌耐药率最低的是米诺环素为31.2%,其次为头孢哌酮/舒巴坦为53.94%;嗜麦芽窄食单胞菌耐药率最低的是米诺环素为5.3%;洋葱伯克霍尔德菌对复方磺胺甲口恶唑、米诺环素耐药率较低,分别为21.05%、15.8%。结论:不同菌种的非发酵G-杆菌对药物的敏感性有较大差异。

       

      Abstract: Objective:To monitor the distribution and drug resistance of clinical isolated common non-fermentative Gram-negative bacilli,so as to provide basis for appropriate use of antibiotics in clinic.Methods:The 728 strains common non-fermentative gram-negative bacilli were collected and their antimicrobial susceptibility was studied.The identification and drug susceptibility tests were detected by paper-disc agar-diffusion method and minimal inhibitory concentration method.The results were evaluated in accordance with the standard of American Clinical Laboratory Information Systems.Results:In the 728 strains non fermentative Gram-negative bacilli,the dominant four strains were Acinetobacter baumannii ( 330 strains ) firstly,Pseudomonas aeruginaosa ( 290 strains ),Stenotrophomonas maltophilia ( 38 strains) and Burkholderia cepacia ( also 38 strains).The main bacterias were most from sputum system,totally 543 strains and the most distribution were detected in intensive care unit ( 308 strains ).The resistant rates of Pseudomonas aeruginosa to imipenem cefoperaxone/sulbactam,piperacillin/tazobactam were all less than 30%.The resistant rates of Acinetobacter baumannii were 31.2% to minocycline,53.94% to cefoperaxone/sulbactam and all lower than others.The resistant rate of Stenotrophomonas maltophilia to minocycline was 5.3%.The resistant rates of Burkholderia cepacia to cotrimoxazole and minocycline were lower than others,21.05% and 15.8% respectively.Conclusions:Different kinds of nonfermentative Gram negative bacilli had a greater difference in drug sensitivity.

       

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