重症监护病房非发酵菌分布及耐药分析

Distribution and drug-resistance analysis of non-fermenting bacteria in intensive care units

目的分析医院重症监护病房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2008年至2009年医院自重症监护病房分离的非发酵菌,对其检出率及药敏结果进行统计分析。结果共检出4 273株非发酵菌,检出率为38%,分离率居前4位的依次是铜绿假单胞菌(44.09%)、鲍氏不动杆菌(27.64%)、嗜麦芽寡养单胞菌(10.58%)和洋葱伯克霍尔德菌(5.99%);4种常见的非发酵菌对常用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。结论医院重症监护病房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 intensive care unit to guide rational application of antibiotics in clinic.Method The non-fermenting bacteria isolated from sputum specimens of patients in intensive care unit from 2008 to 2009 were identified and their drug resistance were analyzed.Result A total of 4 273 strains of non-fermentating bacteria were isolated,representing an isolation rate of 38%,The dominant 4 strains were Pseudomonas aeruginosa（44.09%）,Acinetobacter baumannii（27.64%）,Stenotrophomonas maltophilia（10.58%） and Burkholderia cepacia（5.99%）.High drug resistance to common antibiotics,excluding from β-lactamase inhibitor compound for instance cefoperazone/sulbactam,was revealed in the four species of non-fermenting bacteria.Conclusion Non-fermenting bacteria isolated from hospitalized patients in intensive care unit show higher isolation rate and multidrug resistance.Therefore,pathogenic bacteria identification and antimicrobial susceptibility test should be strengthened to instruct antibiotics properly in clinic.