非发酵菌238株的临床分布及其耐药性

Clinical Distribution and Drug Resistance of 238 Strains of Non-fermentative Bacteria

目的调查中国人民解放军第174医院2010年1月1日—12月31日间非发酵菌的临床分布及其对常用抗菌药的耐药性,为临床合理使用抗菌药物提供参考依据。方法采用VITEK 2-COMPACT全自动细菌鉴定及药敏分析系统,对临床分离的细菌进行菌种鉴定及耐药性测定。结果共分离出238株非发酵菌,占临床细菌总分离率的15.8%。其中,铜绿假单胞菌最多为119株(50.00%),其次为鲍曼不动杆菌70株(29.41%)。非发酵菌在各类标本中的分布以痰类最多,为66.81%;其次是分泌物,为25.63%。病区分布主要为呼吸内科、颅脑外科、肿瘤外科、ICU病房和妇科,分别为32.77%、15.55%、10.92%、10.08%和8.40%。药敏结果显示,铜绿假单胞菌对头孢曲松、氨苄西林、头孢替坦、头孢唑啉、呋喃妥因等呈多种抗菌药物高度耐药,分别为99.16%、98.32%、96.64%、97.48%和94.96%;而鲍曼不动杆菌对这几种抗菌药物的耐药率则均为100%。结论非发酵菌的临床分离率较高,临床分布范围广,耐药现象较严重,值得临床高度重视,临床医生应该根据药敏结果合理使用抗生素。

[Objective]To investigate the clinical distribution and drug resistance of non-fermentative bacteria in the 174th Hospital of PLA from January 1,2010 to December 31,2010,provide the reference for reasonable use of antibiotics in clinic. [Methods]Using VITEK 2-COMPACT automatic bacteria identification and drug sensitivity analysis system,strain identification and drug resistance detection were conducted in clinical isolated bacteria. [Results]238 strains of non-fermentative bacteria were isolated,which accounted for 15.8% of total isolated bacteria.Among them,119（50.00%） strains were Pseudomonas aeruginosa,followed by 70（29.41%） strains of Acinetobacter baumannii.66.81% of non-fermentative bacteria were isolated from the sputum specimens,and 25.63% were isolated from the secretion specimens.The non-fermentative bacteria were commonly detected in respiratory department（32.77%）,craniocerebral department（15.55%）,department of tumor surgery（10.92%）,ICU（10.08%） and gynecologic department（8.40%）.The sensitivity test results showed that Pseudomonas aeruginosa were highly resistant to ceftriaxone（99.16%）,ampicillin（98.32%）,cefotetan（96.64%）,cefazolin（97.48%） and nitrofurantoin（94.96%）.The drug resistance rate of Acinetobacter baumannii to drugs mentioned above reached 100%. [Conclusion]The clinical isolated rate of non-fermentative bacteria was high,which had a wide clinical distribution.It is important to pay attention to serious drug resistance,and clinical doctors should use the antibiotics according to the drug sensitivity results.