2007年至2009年3种非发酵革兰阴性杆菌耐药性分析

Drug resistance analysis of non-fermentative gram-negative bacillus from 2007 to 2009

目的研究自临床分离的铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽寡养单胞菌等3种非发酵革兰阴性杆菌的耐药性及其变迁,为合理使用抗菌药物提供依据。方法临床标本按常规方法分离培养,用生物梅里埃API分析系统鉴定细菌种类,根据CLSI规定的标准,采用纸片扩散法进行体外药敏测定,WHONET软件进行统计分析。结果 2007年至2009年共分离到铜绿假单胞菌310株、鲍曼不动杆菌280株和嗜麦芽寡养单胞菌86株。其中亚胺培南不敏感的铜绿假单胞菌为32.5%,亚胺培南不敏感的铜绿假单胞菌对其他药物的耐药率也明显高于亚胺培南敏感菌株;鲍曼不动杆菌对大部分抗生素的耐药率都高于60%,对亚胺培南、美罗培南3年总的敏感率为51.6%和48.2%;嗜麦芽寡养单胞菌对米诺环素的敏感率为93.8%。比较3年耐药率的变迁,2009年部分抗菌药物耐药性增长的势头得到遏制。结论非发酵菌是引起院内感染的重要病原菌,对多种抗菌药物都有较高的耐药性,合理使用抗生素,加强医院感染的控制对减少细菌耐药性的产生有非常重要的作用。

Objective To isolate non-fermentative Gram-negative bacillus,ie Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia,and analyze drug resistance evolution from 2007 to 2009,and support rational use of antibacterial agents.Method Clincal specimens were routinely processed for bacteria isolation and cultivation.Identification was done by API microbial analysis system（BioMerieux）,in vitro drug sensitivity was analyzed by disk diffusion testing according to CLSI criteria.Statistical analysis was perfomed with WHONET software.Result There were 310 Pseudomonas aeruginosa strains,280 Acinetobacter baumannii strains and 86 Stenotrophomonas maltophilia strains isolated from 2007 to 2009.Among which,32.5% of Pseudomonas aeruginosa isolates were non-susceptible to Imipenem,with higher resistence rate to other drugs compared with Imipenem-susceptible counterparts.Resistence rates of Acinetobacter baumannii isolates to most antibiotics were higher than 60%,with 3 year total susceptibility to Imipenem,Meropenem being 51.6% and 48.2%,respectively.As to Stenotrophomonas maltophilia isolates,the susceptibility to Minocycline was 93.8%.Comparing the 3-year drug resistence evolution profiles,the increasing drug resistence trend was partly curbed in 2009.Conclusion Non-ferm Gram-negative bacillus are significant pathogenic bacteria responsible for nosocomial infection,with high resistence to multiple antibacteria agents.Rational medication and control of nosocomial infection play an important role in decreasing incidence of drug resistence.