2009年下呼吸道非发酵菌的临床分布及耐药性分析

Distribution and Antibiotic Resistance of Non-fermented bacilli in Lower Respiratory Tract Infection in 2009

目的:了解2009年本院下呼吸道非发酵菌的分布及耐药性分析,为临床合理选用抗生素提供依据。方法:细菌鉴定采用VITEK-32系统,用K-B法及VITEK32进行药敏试验。结果:2009年我院下呼吸道标本共分离出1208株病原菌,其中革兰阴性杆菌850株:非发酵菌560株(占所有病原体的46.4%,占革兰阴性杆菌总菌株数65.9%)。非发酵菌中,排前四位依次为铜绿假单胞菌(35.2%)、鲍曼不动杆菌(26.3%)、嗜麦芽假单胞菌(16.4%)和洋葱伯克霍尔德菌(15.2%)。铜绿假单胞菌对头孢他啶、亚胺培南、哌拉西林/他唑巴坦耐药率分别是为34.0%、31.0%、34.0%;洋葱假单胞菌对哌拉西林/他唑巴坦和头孢他啶耐药率较低为4.7%和8.2%;不动杆菌属对亚胺培南耐药率最低为22.4%;嗜麦芽假单胞对左氧氟沙星及复方新诺明耐药率较低,分别为6.5%和14.1%。结论:非发酵菌为院内下呼吸道感染重要病原菌,而且耐药现象严重,治疗应根据药敏结果选用抗生素。

Objective：To investigate the isolation and antimicrobial resistance of non-fermented bacilli isolated from lower respiratory tract infection patients from January to december in 2009 in our hospital for rational antimicrobial therapy in practice.Method：The bacteria indentified by VITEK 32 automatic microorganism identification and susceptibility system,and K-B test was used to analyze the antimicrobial susceptibility.Result：560 strains of non-fermented bacilli isolated were 46.4%（560/1208） of pathogens isolated from lower respiratory tract infection patients and 65.9%（560/850） of Gram-negative bacilli isolated.The top four non-fermented bacteria isolated were pseudomonas aeruginosa （35.2%）,Acinetobacter baumannii（26.3%）,Stenotrophomonas maltophi（16.4%）,Burkholderia cepacia（15.2%）.The resistance rates of P.aeruginosa to ceftazidime,Imipenem,Piperacillin and tazobactam was 34.0%,31.0% and 34.0% respectively;The resistance rates of burkholderia cepacia to piperacillin and Tazobactam,Ceftazidime was 4.7% and 8.2% respectively;The resistance rates of Acinetobacter spp to Imipenem was lowest（22.4%）;The resistance rates of Stenotrophomonas maltophi to Levofloxacin and SMZ-TMP was 6.5% and 14.1% respectively.Conclusion：Non-fermented bacillus were important pathogens of nosocomial infection in lower respiratory tract ith high rates of antibiotic resistance,antimicrobials should be used properly according as the antibiotics sensitivity.