2014-2016年临床主要非发酵菌分布及抗菌药物敏感性变迁分析

Analysis on the change of distribution of the major non-fermenting bacilli and the sensitivity of antibiotics from 2014 to 2016

目的了解该院2014-2016年的非发酵菌临床分布及对抗菌药物敏感性变迁,为临床提供参考依据。方法回顾性分析2014-2016年分离出的2 398株非发酵菌临床分布及抗菌药物敏感性情况。结果3年间共分离出非发酵菌2 398株,主要是鲍曼不动杆菌1 019株(42.5%),其次是铜绿假单胞菌1 016株(42.4%)。ICU主要非发酵菌分离株为727株(30.3%),居所有科室第一,仍以鲍曼不动杆菌占首位。鲍曼不动杆菌对抗菌药物的敏感率绝大多数呈逐年降低趋势,为25.0%~40.0%,尤其是ICU大多数敏感率都低于10.0%。而铜绿假单胞菌对多种抗菌药物如头孢他啶、头孢吡肟、亚胺培南、环丙沙星、左氧氟沙星等敏感率均呈上升趋势,其敏感率均>70.0%。结论鲍曼不动杆菌和铜绿假单胞菌为非发酵菌临床分布的主要病原菌,前者对抗菌药物的敏感率绝大多数呈逐年降低趋势,尤其是ICU形势严峻;后者的敏感率呈逐年上升趋势,有利于临床选择抗菌药物。

Objective To investigate the distribution and antibiotics resistance of the major non-fermenting bacteria in our hospital from 2011 to 2016,then provide a reference for clinic practice.Methods Retrospectively analyze clinical distribution and antimicrobial susceptibility of 2 398 non-fermenting bacteria from 2014 to2016.Results Over the past 3 years,2 398 main non fermented bacteria were isolated,mainly 1 019 strains of Acinetobacter Bauman（42.5%）,followed by Pseudomonas aeruginosa 1 016（42.4%）.The main non fermentative bacteria isolated from ICU were 727 strains（30.3%）,ranking the first in all departments,and the Acinetobacter Bauman was the top.The sensitivity rate of Acinetobacter Bauman to antibiotics was decreasing year by year,as low as 25.0%-40.0%.Especially in ICU,the sensitivity rates were less than 10.0%.The susceptibility rates of Pseudomonas aeruginosa to a variety of antibiotics,such as ceftazidime,cefepime,imipenem,ciprofloxacin,levofloxacin,were all increased,and the sensitivity was70.0%.Conclusion Acinetobacter and Pseudomonas aeruginosa were the main pathogenic bacteria in the clinical distribution of non fermenting bacteria.The most sensitive rate of the former to antibiotics was decreasing year by year,especially the ICU situation was severe,the sensitivity of the latter was increasing year by year,which was beneficial to the clinical selection of antimicrobial agents.