医院感染中非发酵菌的检出率及其耐药性分析

Detecting rate of nonfermenters and their resistance to antibiotics in nosocomial infections

目的:了解非发酵菌在我院医院感染中的分布和检出情况以及非发酵菌的耐药性。方法:应用VITEK-AMS鉴定细菌,K-B法作体外药敏试验,统计分析非发酵菌的检出率和药敏情况。结果:非发酵菌的阳性检出率为14.29％,占总感染率的35.24％,其中,铜绿假单胞菌最为常见(构成比为44.22％),其次为鲍曼不动杆菌(32.17％)和嗜麦芽窄食单胞菌(9.23％)。不同感染部位非发酵菌的感染率各不相同,以呼吸系统(痰或咽拭子标本中)的阳性率最高,而中枢神经系统(脑脊液标本中)的阳性率最低。铜绿假单胞菌对多种抗生素表现为较高的耐药率(45.21％),尤其对舒他西林和复方磺胺甲噁唑的耐药率高(92.18％和82.65％);鲍曼不动杆菌对多种抗生素也表现为较高的耐药率(47.85％),尤其对氨曲南、头孢哌酮和庆大霉素耐药率高(78.56％、77.1 9％和70.21％)。嗜麦芽窄食单胞菌的平均耐药率高达64.02％,对亚胺培南全部耐药,对庆大霉素、美罗培南和氨曲南的耐药率也很高(97.61％、92.83％和91.63％)。结论:我院医院感染中非发酵菌的检出率较高。为及时控制非发酵菌感染并防止耐药菌株的产生,治疗非发酵菌感染应根据体外药敏试验结果选用敏感的抗生素或及时调整抗菌药物。

Objective:To study the detecting rate of nonfermenters and their resistance to the antibiotics in nosocomial infections in our hospital. Methods:The bacteria were identified by VITEK-AMS, the susceptibility tests(K-B method) were done according to the NCCLS standard and the results were analyzed. Results: The detecting rate of nonfermenters was 14. 29%. The most common bacterium was P. aeruginosa (the component ratio was 44. 22%). followed by A. baumannnii (32. 17%) and S.maltophilia(9.23%). The infectious rates of nonfermenters were different at different infectious sites, with the highest rate in the respiratory system and the lowest in central nervous system. The resistant rate to the antibiotics of P. aeruginosa was 45. 21% ,of A. baumannnii 47. 85% and of S. maltophilia 64. 02%. Conclusion:The detecting rate of nonfermenters is rather high in the nosocomial infection in our hospital. Due to the high resistant rates of nonfermenters to the antibiotics , the drugs should be chosen accoding to the result of the drugs susceptibility test.