非发酵革兰阴性杆菌233株临床分布和耐药性分析

Clinical distribution and drug resistance analysis of 233 strains of non fermentative gram negative bacilli

目的分析非发酵革兰阴性杆菌的临床分布和耐药情况,为临床合理选择抗菌药物提供依据。方法采用黑马细菌鉴定仪进行细菌鉴定,Kirby-Bauer法检测非发酵革兰阴性杆菌对12种抗菌药物的药物敏感性。结果233株菌中铜绿假单胞菌占53.2%,恶臭假单胞菌占20.6%,施氏假单胞菌占10.3%,不动杆菌占9.9%,嗜麦芽窄食单胞菌占4.7%;前5种主要非发酵革兰阴性杆菌共占98.7%。铜绿假单胞菌耐药率为17.7%～54.8%,敏感性较高的依次为亚胺培南、哌拉西林/他唑巴坦和阿米卡星;恶臭假单胞菌耐药率为16.7%～56.3%,其中对亚胺培南和哌拉西林/他唑巴坦较敏感;产碱假单胞菌耐药率为16.7%～66.7%,其中对亚胺培南、哌拉西林/他唑巴坦较敏感;不动杆菌属耐药率为13.0%～73.9%,对亚胺培南最敏感。结论铜绿假单胞菌、恶臭假单胞菌、产碱假单胞菌、不动杆菌属是引起医院感染的主要非发酵革兰阴性杆菌,其耐药率高,应根据微生物实验室所提供的细菌耐药情况合理使用抗生素。

Objective To analyse the clinical distribution and drug resistance of non fermentative gram negative bacilli and provide a basis for rational selection of antimicrobial agents.Methods The bacteria identification was done by HEIMA auto microbe system.The Kirby-Bauer method was adopted to detect the sensitivity of 12 antibacterials to non fermentative gram negative bacilli.Results The top five of the isolation rate among 233 strains of non fermenting bacteria were in turn pseudomonas aeruginosa（53.2%）,pseudomonas putida（20.6%）,pseudomonas alcaligenes（10.3%）,acinetobacter（9.9%） and stenotrophomonas maltophilia（4.7%）.Five kinds added up to 98.7%.The drug resistant rate of pseudomonas aeruginosa was 17.7%-54.8%,and have a higher sensitivity to imipenem,piperacillin/tazobactam,and amikacin.The drug resistant rate of pseudomonas putida was 16.7%-56.3%,and have a higher sensitivity to imipenem,and piperacillin/tazobactam.The drug resistant rate of pseudomonas alcaligenes was 16.7%-66.7%,and have a higher sensitivity to imipenem,and piperacillin/tazobactam.The drug resistant rate of acinetobacter was 13.0%-73.9%,and have the highest susceptibility to imipenem.Conclusion Pseudomonas aeruginosa,pseudomonas putida pseudomonas alcaligenes and acinetobacter are the main non fermenting bacteria causing hospital infection,which have the high drug resistant rate to various antibacterial.According to the bacterial drug resistance provided by clinical microbiological laboratory for the rational use of antibiotics.