重症监护病房非发酵菌的分离及耐药性

Isolation and drug resistance of nosocomial infections of non-fermentative bacilli in an intensive care unit

目的了解重症监护病房(ICU)非发酵菌的临床分离状况及常见菌株的耐药性。方法分离出的非发酵菌采用VITEK-60 AMS细菌鉴定仪鉴定,K-B法进行体外药敏试验。结果2005年1月～2007年8月共检出非发酵菌366株,铜绿假单胞菌(PAE)最为常见(45.36%),其次为鲍氏不动杆菌(ABA,23.22%)和嗜麦芽寡养单胞菌(SPM,15.30%);标本来源主要为痰液、引流液和尿液,分别占42.62%、20.77%和15.85%。PAE、ABA和SPM耐药较为严重,且呈多重耐药性。结论ICU非发酵菌以呼吸道感染常见,其耐药现象严重;应根椐药敏结果选用敏感抗菌药物。

Objective To investigate the clinical distribution and drug resistance of nosocomial infections of non-fermen- tative bacilli isolated from an intensive care unit（ICU） in order to guide the rational use of antibiotics. Methods A VITEK-60 AMS system and the Kirby-Bauer methods were used to identify pathogenic bacilli and examine their antibiotic resistance. Results A total of 366 strains of non-fermentative bacteria were isolated from Jan. 2005 to Aug. 2007; the most common pathogen was Pseudornonas aeruginosa （45. 36 %）, followed by Acinetobacter baumannii （23. 22 %） and Stenotrophomonas rnaltophilia （ 1S. 30 % ）. The samples were mainly sputum （42.62 % ）, drainage fluid （20.77 % ）, and urine（IS. 85%）. P. aeruginosa, A. baumannii, and S. maltophilia had high levels of antibiotic resistance and multi- drug resistance. Conclusion Infections of respiratory tract and wound caused by non-fermentative bacilli are common in ICU, and drug resistance is serious. The drugs should be chosen according to the results of the antimicrobial susceptibili- ty tests.