常见非发酵菌的临床分布与耐药性分析

Distribution and Drug Resistance of Clinically Common Non-fermentative Gram-negative Bacilli

目的了解医院感染非发酵菌的临床分布特点及耐药性。方法API20NE进行菌种鉴定,K-B法进行药敏试验。结果7年间医院从各种临床标本中共分离出21348株细菌,其中非发酵菌3767株,占革兰阴性杆菌的17.6%;居前4位的依次为铜绿假单胞菌占43.8%、不动杆菌属占39.9%、嗜麦芽寡养单胞菌占6.7%、洋葱伯克霍尔德菌占2.7%;铜绿假单胞菌对头孢哌酮/舒巴坦、阿米卡星、头孢吡肟、美罗培南的耐药率<20.0%;不动杆菌属对亚胺培南、美罗培南、头孢哌酮/舒巴坦、米诺环素的耐药率<20.0%;嗜麦芽寡养单胞菌对米诺环素、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、左氧氟沙星的耐药率<20.0%;洋葱伯克霍尔德菌对米诺环素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率<20.0%。结论非发酵菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、米诺环素、亚胺培南和美罗培南的敏感性最高,为临床治疗非发酵菌引起感染的首选药物。

OBJECTIVE To explore the characteristics of the clinical distribution and drug resistance of non-fermentative Gram-negative bacilli in nosocomial infection.METHODS The bacteria were identified by API 20NE.Antibiotic susceptibility test was performed by K-B disk diffusion method.RESULTS The rate of non-fermentatives in Gram-negative bacilli was 17.6%.The dominant strains were Pseudomonas aeruginosa（43.8%）,Acinetobacter spp（39.9%）,Stenotrophomonas maltophilia（6.7%）,and Burkholderia cepacia（2.7%）.The resistant rates of P.aeruginosa to cefoperaxone/sulbactam,amikacin,cefepime and meropenem were less than 20%.The resistant rates of Acinetobacter spp to imipenem,meropenem,cefoperaxone/sulbactam and minocycline were less than 20%.The resistant rates of S.maltophilia to minocycline,cefoperaxone/sulbactam,piperacillin/tazobactam and levofloxacin were less than 20%.The resistant rates of B.cepacia to minocycline,piperacillin/tazobactam and cefoperaxone/sulbactam were less than 20%.CONCLUSIONS The sensitivities of non-fermentative Gram-negative bacilli to cefoperaxone/sulbactam,piperacillin/tazobactam,minocycline,imipenem and meropenem were the highest.These antibiotics may be chosen first for the clinical treatment.