2014—2018年梅州地区非发酵菌的临床分布及耐药性分析

Analysis of clinical distribution and drug resistance of non-fermentative bacteria in meizhou area from 2014 to 2018

目的研究非发酵菌的临床分布及其对主要抗菌药物的耐药状况,为临床合理使用抗菌药物提供依据。方法回顾性分析2014—2018年梅州地区临床分离的非发酵菌菌种构成、标本来源、科室分布及药敏结果。结果2014—2018年共分离出非发酵菌9445株,其检出率前三位依次为铜绿假单胞菌(42.8%)、鲍曼不动杆菌(37.0%)、嗜麦芽窄食单胞菌(10.3%);所有非发酵菌分离株以呼吸道标本为主(66.95%),其次为分泌物(17.51%);感染科室分布以ICU科(20.94%)和呼吸科(16.08%)最多。药敏显示,鲍曼不动杆菌对11种主要抗菌药物的耐药率除阿米卡星(40%左右)和替加环素(20%左右)外,均高于60%;铜绿假单胞菌对11种主要抗菌药物耐药率除头孢哌酮/舒巴坦(40%左右),其余均低于30%;嗜麦芽窄食单胞菌对4种主要药物的耐药率均较低。结论非发酵菌的检出率较高,多重耐药情况严重,应引起医院监管部门的重视,做好院内感染监控,防止院内感染暴发流行。

Objective To investigate the distribution and antibiotic resistance of Non-fermentation bacteria isolates and to provide reference for clinical rational use of antimicrobial drugs.Methods A retrospective analysis was performed for the ratio of isolates,specimens source,clinical distribution and drug susceptibility test of non-fermentation bacteria in Meizhou area from January 2014 to December 2018.Results A total of 9445 non-fermentative strains were isolated from 2014 to 2018.The top three detection rates were Pseudomonas aeruginosa(42.8%),Acinetobacter baumannii(37.0%),and maltophilia Bacteria(10.3%);all non-fermentative isolates were mainly respiratory specimens(66.95%),followed by secretions(17.51%);infection departments were distributed in ICU(20.94%)and respiratory departments(16.08%)is the most.Drug sensitivity showed that the resistance rate of Acinetobacter baumannii to 11 major antibiotics was higher than 60%except for amikacin(about 40%)and tigecycline(about 20%),the resistance rate of Pseudomonas aeruginosa to 11 major antibiotics except cefoperazone/sulbactam(about 40%),and the rest were less than 30%,the resistance rate of Stenotrophomonas maltophilia to four main drugs was lower.Conclusion The detection rate of non-fermenting bacteria is high,and the multi-drug resistance is serious.It should be paid attention to by the hospital supervision department,do a good job in monitoring the infection of the hospital to prevent the outbreak of nosocomial infection.