3种常见非发酵革兰阴性菌的耐药性探讨

Drug resistance of three common non-fermenting gram-negative bacilli

目的探讨医院感染常见的3种非发酵革兰阴性杆菌的耐药性,为临床合理用药提供科学依据。方法回顾性调查铜绿假单胞菌(PAE)、鲍氏不动杆菌(ABA)、嗜麦芽寡养单胞菌(SMA)医院感染现状及耐药性。结果 PAE和ABA对碳青霉烯类抗菌药物和头孢哌酮/舒巴坦耐药率较低,为14.4%～22.2%;SMA对亚胺培南100.0%耐药,PAE对头孢唑林、头孢呋辛、头孢噻肟、庆大霉素耐药率均>40.0%,ABA对抗菌药物耐药率比PAE更严重。结论非发酵菌为医院感染的重要致病菌,且大部分耐药严重,应注重细菌耐药性的监测,严防医院感染暴发。

OBJECTIVE To investigate the drug resistance of three common nonfermenting gram-negative bacilli so as to provide evidence for clinical use of drugs.METHODS Current state and drug resistance of Pseudomonas aeruginosa（PAE）,Acinetobacter baumannii（ABA） and Stenotrophomonas maltophilia（SMA） were investigated retrospectively.RESULTS The PAE and ABA showed lower drug resistance rate to carbapenems and cefoperazone/sulbactam（14.4%~22.2%）.However,the resistance rate of SAM against imipenem was 100.0% and PAE against cephazoline,cefuroxime,cefotaxime,gentamicin were all above 40.0 %.ABA had a higher rate of drug resistance to antiseptic drugs than PAE.CONCLUSION The nonfermenting gram-negative bacilli are the major pathogens in nosocomial infections and often show serious drug resistance.Therefore,bacterial resistance monitoring should be highlighted and the outbreaks in hospital infections should be strictly controlled.