2010至2017年间4760株常见革兰阴性非发酵菌及其耐药性动态变迁分析

Analysis of 4760 Gram-negative non-fermentative bacteria and their dynamic changes of drug resistance from 2010 to 2017

目的了解亚胺培南对革兰阴性非发酵菌的耐药性及其变化趋势,为临床合理用药提供依据。方法收集2010~2017年间从右江民族医学院附属医院就诊患者标本分离的革兰阴性非发酵菌,进行鉴定及药敏试验,并对结果进行统计分析。结果 4760株革兰阴性非发酵菌分离自痰液、脓液、尿液及血液等标本,主要包括铜绿假单胞菌(44.03%)、鲍曼不动杆菌(31.62%)、嗜麦芽窄食单胞菌(9.64%)和洋葱伯克霍尔德菌(2.63%)等菌株。铜绿假单胞菌和嗜麦芽窄食单胞菌对大部分常见抗菌药物耐药率低于10%,鲍曼不动杆菌对大部分常见抗菌药物耐药率高于30%,洋葱伯克霍尔德菌对部分常见抗菌药物耐药率高于70%。铜绿假单胞菌对亚胺培南的耐药率较低且逐年下降,鲍曼不动杆菌对亚胺培南的耐药率较高且波动较大,洋葱伯克霍尔德菌对亚胺培南耐药率较高且波动不大。结论亚胺培南对铜绿假单胞菌抗菌活性较强,但对鲍曼不动杆菌和洋葱伯克霍尔德菌抗菌活性较差,应引起关注。

Objective To understand the resistance of imipenem to Gram-negative non-tennentative bacteria and its changing trend, so as to provide evidence tor rational clinical use of antimicrobial drugs. Methods Gram-negative non-ter-mentative bacteria isolated from the specimens of patients from the Affiliated Hospital of Youjiang Medical University tor Na-tionalities from 2010 to 2017 were collected for identification and drug sensitivity test, and the results were statistically ana-lyzed.Results 4760 Gram-negative non-tennentative bacteria were isolated from the samples of sputum, pus, urine and blood, including Pseudomonas aeruginosa （44.03%）, Acinetobacter baumannii （31.62%）, Stenotrophomonas maltophilia （9.64%） and Burkholderia cepacia （2.63%）.The resistance rate of Pseudomonas aeruginosa and Stenotrophomonas malto- philia to most common antimicrobial agents was less than 10%, and the resistance rate of Acinetobacter baumannii to most common antimicrobial agents was higher than 30%.The resistance rate of Burkholderia cepacia to some common antimicrobial agents was higher than 70%.The resistance rate of Pseudomonas aeruginosa to imipenem was relatively low and decreased year by year.The resistance rate of Acinetobacter baumannii to imipenem was high and fluctuated greatly.Burkholderia cepacia had a high resistance rate to imipenem with little fluctuation.Conclusion finipenem has strong antibacterial activity against Pseudomonas aeruginosa, but it has poor antibacterial activity against Acinetobacter baumannii and Bacillus cepacia, which should be caused close attention.