某院2013～2014年鲍曼不动杆菌及铜绿假单胞菌全院感染性监测及耐药性分析

Surveillance and Drug Resistance Analysis of Acinetobacter Sp. and Pseudomonas Aeruginosa Infection in a Hospital From 2013 to 2014

目的对我院常见的非发酵菌鲍曼不动杆菌和铜绿假单胞菌进行感染性监测并且对其耐药性进行分析。方法收集2013年1月~2014年12月住院和门诊患者送检的各类标本并进行分离培养和鉴定;采用世界卫生组织（WHO）-NET5.4软件对病原菌的耐药性进行分析。结果 2013~2014年共分出鲍曼不动杆菌312株,铜绿假单胞菌1 364株。标本来源均以痰液为主,临床科室来源最多的是ICU,其次是呼吸科。铜绿假单胞菌对复方甲恶唑的耐药率为3.3%,对丁胺卡那霉素、妥布霉素、头孢哌酮/舒巴坦和左氧氟沙星的耐药率分别为5%、5.3%、5.5%和9.4%,对米诺环素、头孢曲松、头孢噻肟的耐药率较高,分别为56.8%、55.3%、45.6%。对其它抗菌药的耐药率在10%~30%。鲍曼不动杆菌对米诺环素的耐药率为4.2%,对头孢哌酮/舒巴坦的耐药率为11.4%,对复方磺胺甲恶唑耐药率最高,为51.9%,对其它常用药物的耐药率在30%~50%。结论铜绿假单胞菌及鲍曼不动杆菌感染分布广泛,耐药性作用明显。临床应加强对这两种院感菌耐药性的监控以防止耐药菌株的传播。

Objective To explore the surveillance and drug resistance of non fermenting bacteria acinetobacter bauman and pseudomonas aeruginosa in our hospital. Methods All kinds of various specimens from inpatient and outpatient were isolated and cultured and identified from January 2013 to December 2014.The drug resistance of pathogenic bacteria was analyzed by using-NET 5.4 software in the world health organization（WHO）. Results Bauman was divided into 312 strains of acinetobacter,1 364 pseudomonas aeruginosa from 2013 to 2014,most specimens were from sputum,the source of most clinical department is ICU,followed by department of respiration. pseudomonas aeruginosa resistant to compound sulfamethoxazole was 3.3%,for butylamine card that mildew,tobramycin,cefoperazone/sulbactam and levofloxacin resistance rate were 5%,5.3%,5.5% and 9.4%,resistant to minocycline,ceftriaxone,cefotaxime was higher,respectively 56.8%,55.3%,45.6%,the resistance rate to other antimicrobial agents was 10% ~ 30%,bauman acinetobacter resistance to minocycline was 4.2%,to cefoperazone/sulbactam was 11.4%,to compound sulfamethoxazole resistance was the highest,was 51.9%,the drug resistance rate of other common drugs was 30% ~ 50%. Conclution The infection of pseudomonas aeruginosa and bauman is widespread,and the drug resistance is obvious. Clinical should strengthen the monitoring of drug resistance of these two kinds of hospital to prevent the spread of resistant strains.