ICU感染患者中非发酵菌分布与耐药性分析

Distribution and drug resistance of non-fermenting bacteria isolated from ICU patients with infections

目的分析重症监护病房(ICU)感染患者中非发酵菌的分布及耐药性,为临床抗感染治疗提供依据。方法选取2013年6月-2015年6月ICU住院患者200例作为研究对象,采集患者的各类标本并对其中的非发酵菌进行菌种鉴定和药敏试验。结果在各类标本中,共分离出非发酵菌253株,其中,痰液和引流液中的非发酵菌构成比最高,分别占47.4%和12.3%;在分离出的非发酵菌中,以铜绿假单胞菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌的构成比最高,分别占38.7%、28.1%和22.9%;分离出的主要非发酵菌对于常用抗菌药物具有较高的耐药率,铜绿假单胞菌对阿米卡星、妥布霉素、头孢哌酮/舒巴坦较敏感,耐药率<25.0%,鲍氏不动杆菌对头孢哌酮/舒巴坦、阿米卡星、米诺环素较敏感,耐药率<43.0%,嗜麦芽寡养单胞菌对米诺环素、头孢哌酮/舒巴坦、左氧氟沙星较敏感,耐药率<28.0%。结论 ICU住院患者中非发酵菌的分布和耐药性具有一定的特征,临床医师应准确识别,及时监控其变化趋势,选取敏感抗菌药物进行抗感染治疗,从而达到提高治疗效果、改善患者预后的目的。

OBJECTIVE To analyze the distribution and drug resistance of non-fermenting bacteria isolated from patients with infections in intensive care unit（ICU）so as to provide guidance for clinical treatment of the infections.METHODS A total of 200 patients who were hospitalized in the ICU from Jun 2013 to Jun 2015 were recruited as the study objects,then the specimens were collected from the enrolled patients,the isolated non-fermenting bacteria were identified,and the drug susceptibility testing was performed.RESULTS Totally 253 strains of non-fermenting bacteria were isolated from the specimens,of which 47.4% were isolated from sputum specimens,and 12.3%were isolated from drainage fluid.Among the isolated non-fermenting bacteria,the Pseudomonas aeruginosa,Acinetobacter baumannii,and Stenotrophomonas maltophilia accounted for 38.7%,28.1%,and 22.9%,respectively.The major species of the isolated non-fermenting bacteria were highly resistant to the commonly used antibiotics;the drug resistance rates of the P.aeruginosato amikacin,tobramycin,and cefoperazone-sulbactam were less than 25.0%;the A.baumannii strains were susceptible to cefoperazone-sulbactam,amikacin,and minocycline,with the drug resistance rates less than 43.0%;the drug resistance rates of the S.maltophiliato minocycline,cefoperazone-sulbactam,and levofloxacin were less than 28.0%.CONCLUSION The distribution and drug resistance of the non-fermenting bacteria isolated from the hospitalized ICU patients show certain characteristics,and it is necessary for the clinicians to accurately identify,monitor the changes in a timely manner,and choose sensitive antibiotics for treatment of the infections so as to raise the therapeutic effect and improve the prognosis of the patients.