常见非发酵革兰阴性杆菌耐药性的监测及变迁

目的:连续监测非发酵革兰阴性杆菌的耐药性,了解不同年度非发酵革兰阴性杆菌感染状况及耐药性变化,为临床合理用药提供依据。方法:对2009～2010年收治患者送检的标本进行培养,用ATB Expression智能系统对细菌进行鉴定及药敏试验,对检出的两种主要非发酵革兰阴性杆菌临床分布及耐药性进行分析。结果:2年共检出非发酵菌861株,分别检出铜绿假单胞菌364株(42.3%),鲍曼不动杆菌357株(41.4%)。标本主要来源于呼吸内科,其次为颅脑外科。头孢哌酮/舒巴坦是16种被监测抗菌药物中抗菌活性较强,耐药率<20%;其次为美洛培南和亚胺培南,耐药率约<30%。检出目的菌的绝对数和耐药率均有逐年增加的趋势。结论:非发酵革兰阴性杆菌耐药性监测很有必要,了解其耐药性变迁,并按照药敏结果选择药物隔离治疗,防止耐药菌的传播和爆发。

Objective：To investigate the isolate status and the changes of antimicrobial resistance of common non-fermented Gram-negative bacilli in various years so as to provide guidance for rational clinical application of antibiotics in our hospital.Methods：All specimens isolated from hospitalized patients between 2009 and 2010 were cultured with routine procedure and bioMrieux ATB Expression auto-system was applied for bacteria identification and antimicrobial resistance.Results：A total of 861 strains of non-fermented Gram-negative bacilli were isolated between 2009 and 2010.The first 2 non-fermented Gram-negative bacilli were Pseudomonas aeruginosa;and acinetobacter baumannii,accounted for 42.3% and 41.4%,respectively.The main specimens were collected from department of respiratory and neurosurgery.The resistant rate of non-fermented Gram-negative bacilli to cefoperazone/sulbactam was under 20%,obviously lower than other antibiotics,which was followed by meropenem and imipenem,less than 30%.Increased prevalence of resistant strains has been occurring year after year.Conclusion：It is necessary to perform periodicl surveillance and study the changes of antimicrobial resistance of non fermented Gram-negative bacilli,which can prevent from the spread of bacterial resistance.