下呼吸道感染非发酵菌的流行情况和耐药现状

Analysis on the epidemic status of nonfermentative bacteria in low respiratory tract infection and their drug resistance

目的总结我院2004年下呼吸道感染住院患者非发酵菌的流行情况及耐药现状,为临床合理应用抗菌药物提供指导依据。方法收集2004年我院下呼吸道感染住院患者痰培养结果为非发酵菌的数据,用WHONET5软件统计分析。结果2004年我院下呼吸道感染住院患者痰培养非重复阳性标本共1367份,革兰阴性菌684株；非发酵菌321株(占所有病原体的23．5%,占革兰阴性菌的47%),其中,铜绿假单胞菌152株,占47%；不动杆菌属共106株,占33%；嗜麦芽寡养单胞菌28株,占9%；洋葱假单胞菌17株,占5%。铜绿假单胞菌对哌拉西林/三唑巴坦敏感率最高,对亚胺培南、阿米卡星、头孢他啶尚敏感；不动杆菌属对亚胺培南、哌拉西林/三唑巴坦和头孢哌酮/舒巴坦较敏感；嗜麦芽寡养单胞菌、洋葱假单胞菌对左氧氟沙星、哌拉西林/三唑巴坦和头孢哌酮/舒巴坦较敏感。结论下呼吸道感染病原体中非发酵菌占据越来越大的比例,减少医源性感染、合理选用抗菌药物对提高治愈率至关重要。

Objective To investigate the epidemic situation of nonfermentative bacteria in low respiratory tract infection and their drug resistance and guide rational use of antimicrobials. Methods The data of nonfermentative bacteria from the sputum specimens of inpatients in our hospital with low respiratory tract infection in 2004 were collected and analyzed with the software WHONETS. Results Of 1367 positive sputum specimens, 684 strains of Gram-negative bacteria and 321 strains of nonfermentative bacteria were detected. The nonfermentative bacteria were mainly comprised of 152 strains of Pseudomonas aeruginosa, 106 strains of Acinetobacter sp., 28 strains of Stenotrophomonas maltophi and 17 strains of Burkholderia cepaci, and their rates were 47% , 33% , 9%and 5% respectively. Pseudomonas aeruginosa had the highest susceptible rate to piperacillin/tazobactam and also susceptible to imipenem, amikacin and ceftazidime. Acinetobacter sp. was susceptible to imipenem, piperacillin/tazobactam and cefoperazone/sulbactam. Both of Stenotrophomonas maltophi and Burkholderia cepaci were susceptible to levofloxacin, piperacillin/tazobactam and cefoperazone/sulbactam. Conclusion The isolation rate of nonfermenters were increasing in low respiratory tract infection, and the ways to improve the cure rate were to avert nosocomial infection and choose antimicrobials properly.