非发酵菌株血培养临床分布及药敏分析

Clinical distribution and drug sensitivity of afermentans bacteria in blood culture

目的：研究血培养非发酵菌株临床分布及药敏情况,预防医院感染。方法：选取2012-01-2013-12在本院进行血培养的8 245份标本,BacT/Alert3D血培养仪中培养,Vitek compact 2微生物全自动鉴定仪进行鉴定,K-B法对14种抗生素药敏测定,计算耐药率（%）。结果：8 245份标本血培养阳性率为5.87%,阳性血培养非发酵菌株阳性率为0.485%,占阳性标本的8.26%。40株阳性血培养非发酵菌株临床分布前三的科室为血液科、消化内科和ICU,平均血培养时间（14.74-34.80）h,1例荧光假单胞菌除外。40株阳性血培养非发酵菌株检出前三的菌株分别为铜绿假单包菌、不动杆菌和鲍曼不动杆菌。不动杆菌药敏实验中,耐药率最低的3种抗生素为头孢哌酮/舒巴坦,复方新诺明和米诺环素,耐药率分别为14.29%、25.00%和33.33%。假单胞菌属药敏实验中,耐药率最低的3种抗生素为头孢哌酮/舒巴坦、左氧氟沙星和头孢他啶,耐药率分别为4.55%、4.17%和44.17%。结论：非发酵菌对头孢哌酮/舒巴坦表现为较低的耐药率,适合血培养阳性非发酵菌临床经验用药。

Objective：To investigate the clinical distribution and drug sensitivity of afermentans bacterias in blood culture. Methods：A total of 8 245 blood samples collected from January 2012 to December 2013 in our hospital were cultured by BacT/Alert3D method. Forty afermentans bacteria were identified by Vitek compact 2 bacteria identification system, and Kirby-Bauer（K-B） method was used for the antibiotic susceptibility test. The data was statistically analyzed. Results： The average culturing time for afermentans bacteria was between （14.74 - 34.80） h, except for Pseudomonas- ftuorescens. The most common afer -mentans bacterium were Pseudomonas aeruginosa, followed by Acinetobacter and Acinetobacter baumannil. These bacteria had various resistances to all detected antibiotics. The acinetobacter were weakly resistant to Sulbaetam/Cefopcrazone, Paediatrie Compound Sulfamethoxazole tablets and Minocycline, and the rate was 14.29% ,25.00% and 3.33% respectively. The Pseudomonas were lowly resistant to Sulbactam/ Cefopcrazone, Levofloxacin/ Ceftazidime, and the rate was 4.550%, 4.17% and 44. 17 % respectively. Conclusion：The antibiotic susceptibility test shows that afermentans bacteria were lowly resistant to Sulbactam/Cefopcrazone which should be used for antibiotic treatment clinically.