非发酵菌825株临床分布特征及耐药性分析

Clinical distribution and drug resistance of 825 strains of non-fermentative bacilli

目的 对临床分离的非发酵菌的流行情况及其对常见抗生素的耐药谱特征进行分析,指导临床合理选择抗菌药物.方法 对各类临床标本培养分离出的825株非发酵菌进行回顾性分析.结果 临床分离无重复非发酵菌825株,居前3位的非发酵菌分别是铜绿假单胞菌301株（36.48％）,鲍氏不动杆菌279株（33.81％）,嗜麦芽寡养单胞菌245株（26.69％）.标本分布主要为痰标本580株（70.30％）、尿液105株（12.73％）和咽拭子68株（8.24％）,科室分布主要为呼吸内科290株（35.15％）,外科212株（25.70％）,ICU125株（15.03％）；铜绿假单胞菌对复方磺胺甲恶唑、头孢噻肟、头孢曲松高度耐药,均大于85.00％；鲍氏不动杆菌对阿米卡星、氨曲南、头孢他啶耐药率相对高,均大于36.00％；但超过95.00％铜绿假单胞菌和鲍氏不动杆菌株均对亚胺培南和美罗培南敏感.嗜麦芽寡养单胞菌对头孢吡肟、亚胺培南、美洛培 南、头孢噻肟、氨曲南高度耐药,均为100.00％,但对米诺环素较敏感.结论 非发酵菌是医院感染的主要致病菌,且对抗菌药物呈多重耐药.

Objective To analyze the epidemiological status and drug resistance to common antibiotics of non-fermentative bacilli in our hospital,in order to provide the guideline for reasonable use of antibiotics.Methods A total of 825 strains of non-fermentative bacilli from various clinical specimen were analyzed retrospectively.Results A total of 825 strains of non repetitive non-fermentative bacilli were isolated.The first of the three vibrionaceae were 301 strains Pseudomonas Aeruginosa accounted for 36.48％,279 strains of Acinetobacter baumannii accounted for 33.81％,a few malt raise form afterbirth fungus 245 plants accounted for 26.69％.Strains isolated from phlegm,urine and pharynx swab were 580（70.30％）,105（12.73％） and 68（8.24％） respectively.Infections with non-fermentative bacilli occurred in the department of respiratory medicine,surgery and ICU were 290 （35.15％）,212 （25.70％） and 125 （15.03％） respectively.The susceptibility results of antibiotics showed that the resistant rate of bactrim,Cefotaxime,and Ceftriaxone was beyond 85.00％ with Pseudomonas Aeruginosa.Acinetobacter baumannii strains of Amikacin,Aztreonam,cefotaxime resistance rate was beyond 36.00％,while beyond 95.00％strains of Pseudomonas Aeruginosa and Acinetobacter baumannii were sensitive with Imipenem and Meropenem.The resistant rate of Cefepime,Imipene,m,Meropenem,Cefotaxim-c,Aztreonam was beyond 100.00％ with Stenotrophomonas maltophilia,while which were sensitive with Minocycline.Conclusion Non-fermentative Bacilli hospital infection is the main pathogenic bacteria,and existence multiple drug resistance to antimicrobial agents.