两种常见非发酵菌的临床分布及耐药性分析

Distribution and drug resistance of clinically two common non-fermentive gram-negative bacilli

目的分析铜绿假单胞菌(PAE)和鲍氏不动杆菌(ABA)的临床分布特点及耐药性,为临床合理应用抗菌药物提供依据。方法回顾性分析医院2008年10月-2011年9月分离的904株铜绿假单胞菌、751株鲍氏不动杆菌的感染特征和耐药性。结果 PAE和ABA临床标本主要来源于痰液,分别占78.5%和80.8%,检出率以重症监护病房(ICU)最高,分别为30.6%和46.2%;PAE对阿米卡星耐药率为3.9%,妥布霉素为5.5%,哌拉西林/他唑巴坦为9.0%,庆大霉素为9.8%,环丙沙星为20.9%,亚胺培南为21.8%;ABA对阿米卡星的耐药率较低为4.7%,其余均>40.0%。结论两种常见非发酵菌对抗菌药物的耐药率存在差异,临床医师应根据药敏结果选择敏感的抗菌药物进行治疗,同时,应加强ICU的消毒隔离措施。

OBJECTIVE To analyze the distribution and drug resistance of Pseudomonas aeruginosa（PAE） and Acinetobacter baumannii（ABA） and provide evidence for rational use of antimicrobial agents in clinic.METHODS The characteristics of infection and drug resistance of 904 PAE and 751 ABA isolated from clinical wards from Oct.2008 to Sep.2011 were analyzed retrospectively.RESULTS PAE and ABA clinical specimens were mainly from sputum,78.5% and 80.8%,respectively.Highest detection rate of PAE and ABA was found in intensive care unit（ICU）,30.6% and 46.2% respectively.The resistance rates of PAE to amikacin was 3.9%,to tobramycin was 5.5%,to piperacillin/tazobactam was 9.0%,to gentamicin was 9.8%,to ciprofloxacin was 20.9% and to imipenem was 21.8%.The resistance rates of ABA were higher than 40.0% except for amikacin 4.7%.CONCLUSION Resistance rates of two common kinds of non-fermentive bacilli to antimicrobial drugs are different,and clinicians should apply antibiotics referring to the results of susceptibility test and disinfection of ICU should be intensified.