下呼吸道感染中非发酵菌的分布及耐药分析

Distribution and Drug-resistance Analysis of Non-fermenting Bacteria in Patients with Lower Respiratory Tract Infection

目的分析医院下呼吸道非发酵菌感染的耐药情况，以指导临床合理使用抗菌药物。方法回顾性分析2007-2008年医院自下呼吸道分泌物中分离的非发酵菌，对其检出率及药敏结果进行统计分析。结果共检出1283株非发酵菌，检出率为55．42％，其中铜绿假单胞菌最多（35．93％），其次为鲍氏不动杆菌（27．59％）、嗜麦芽寡养单胞菌（17．01％）、洋葱伯克霍尔德菌（11．54％）；4种常见的非发酵菌对常用的抗菌药物耐药性均较高，头孢哌酮／舒巴坦等含酶抑制剂的复合型抗菌药物对非发酵菌有较高的敏感性。结论医院下呼吸道感染中非发酵菌检出率高且耐药性强，应加强临床细菌学的检测，按照药敏试验结果合理用药。

OBJECTIVE To explore the distribution and antibiotics resistance of non-fermenting bacteria in hospitalized patients with lower respiratory tract infection to guide rational application of antibiotics in clinic. METHODS The non-fermenting bacteria isolated from sputum specimens of patients with lower respiratory tract infection from 2007 to 2008 were identified and their drug resistance were analyzed. RESULTS A total of 1283 strains of non-fermentating bacteria were isolated, representing an isolation rate of 55. 42%, in which included Pseudornonas aeruginosa ,Acinetobacter baurnannii , Stenotrophornonas maltophilia and Burkholderia cepacia and accounted for 35.93 %, 27.59%,17.01% and 11.54 %, respectively. High drug resistance to common antibiotics, excluding from β-1actamase inhibitor compound for instance cefoperazone/sulbactam, was revealed in the four species of non-fermenting bacteria. CONCLUSIONS Non-fermenting bacteria isolated from hospitalized patients with lower respiratory tract infection show higher isolation rate and multidrug resistance, therefore, pathogenic bacteria identification and antimicrobial susceptibility test should be strengthened to instruct antibiotics properly in clinic.