我院常见非发酵革兰阴性杆菌的分布和耐药性分析

Distribution and susceptibility of common nonfermentative gram-negative bacilli in our hospital

目的了解我院常见的非发酵革兰阴性杆菌的分离情况和耐药特点,为临床用药提供参考。方法细菌鉴定采用法国生物梅里埃公司的鉴定卡,药敏试验采用K-B扩散法,应用Whonet5软件统计铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌的耐药率。结果铜绿假单胞菌对阿米卡星、头孢吡肟、头孢哌酮-舒巴坦的耐药率均低于20%;鲍曼不动杆菌对亚胺培南的耐药率最低,为0.9%,其次为头孢哌酮-舒巴坦5.6%,头孢吡肟、阿米卡星的耐药率分别为24.1%、24.1%,而第一、二代头孢菌素耐药率超过80%;嗜麦芽窄食单胞菌对替卡西林-克拉维酸、头孢哌酮-舒巴坦和复方磺胺甲噁唑的耐药率最低,分别为2%、0%和6%。结论3种非发酵菌是一类多重耐药且耐药率较高的细菌,应根据药敏试验结果选用抗菌药物。

Objective To investigate the prevalence and susceptibility of nonfermentative gram-negative bacilli in our hospital for the purpose of guiding empirical antibiotic therapy. Methods API system was applied for bacterial identification. K B disk diffuse method was used in susceptibility testing. Whonet 5 software was used for data analysis. P. aeruginosa, A. baumannii and S. rnaltophilia isolates were included in this study. Results Less than 20% of P. aeruginosa isolates were resistant to amikacin, cefepime or cefoperazon-sulbactam. For A. baumannii, the most active compounds tested were imipenem and cefoperazone-sulbactam with resistance rates of 0.9% and 5.6% respectively. And 24. 1% of A. baumanni isolates were resistant to cefepime and amikacin. In addition, more than 80% of A. baumanii isolates were resistant to the first and second generation cephalosporins. The resistance rates of S. maltophilia to ticarcillin- clavulanic acid, cefoperazone sulbactam and SMZ-TMP were 2%, 0% and 6% respectively. Conclusions The three species of gram-negative bacilli are a group of multi resistant bacte ria which are becoming increasingly resistant in hospital. Antimicrobial therapy should be decided according to the results of susceptibility testing.