社区获得性肺部感染患者非发酵菌的检出率、分布及药敏性分析

Detection Rate, Distribution and Drug Sensitivity Analysis of Non-fermenting Bacteria in Patients with Community-acquired Lung Infection

目的分析社区获得性肺部感染患者非发酵菌的检出率、分布及药敏性。方法以2019年1月-2020年6月该院呼吸科患者4132份的痰液、支气管刷及肺泡灌洗液中培养出411例非发酵菌标本为对象,分析其临床检出率、分布与药敏试验结果。结果4132份送检标本中非发酵菌检出率为9.95%,其中铜绿假单胞菌占比为72.99%,以黏液型铜绿假单胞菌为主,其次是不动杆菌属占13.14%,,其他非发酵菌占7.79%,嗜麦芽窄食单胞菌占6.08%。药敏试验中,铜绿假单胞菌对多粘菌素B敏感率96.33%最高,对阿米卡星敏感率高达87.33%;不动杆菌属对多粘菌素B敏感率98.15%最高,对米诺环素敏感率为94.44%,对亚胺培南敏感率达85.19%;嗜麦芽窄食单胞菌对米诺环素敏感率96.00%最高,对阿米卡星和左氧氟沙星的敏感率都是72.00%。结论从社区获得性肺部感染患者培养出的非发酵菌中,以黏液型铜绿假单胞菌最为多见,其次是不动杆菌属菌、其他非发酵菌和嗜麦芽窄食单胞菌,且不同菌株对于临床抗菌药物的药敏性不尽相同,临床治疗应结合其对抗菌药物的药敏性予以合理用药。

Objective To analyze the detection rate,distribution and drug sensitivity of non-fermenting bacteria in patients with community-acquired lung infection.Methods From January 2019 to June 2020,411 specimens of non-fermenting bacteria were cultured from 4132 samples of sputum,bronchial brush and alveolar lavage fluid of patients in the respiratory department of the hospital.Analyzed its clinical detection rate,distribution and drug susceptibility test results.Results The detection rate of non-fermenting bacteria in the 4132 samples submitted for inspection was 9.95%,of which pseudomonas aeruginosa accounted for 72.99%,with mucilage pseudomonas aeruginosa as the main species,followed by acinetobacter accounted for 13.14%,other non-fermenting bacteria accounted for 7.79%,and stenotrophomonas maltophilia accounted for 6.08%.In the drug susceptibility test,pseudomonas aeruginosa had the highest sensitivity to polymyxin B(96.33%),and the sensitivity rate to amikacin was as high as 87.33%;acinetobacter was sensitive to polymyxin B(98.15%);the highest rate of sensitivity to minocycline was 94.44%,the sensitivity rate to imipenem reached 85.19%;the highest sensitivity rate to minocycline was 96.00%of Stenotrophomonas maltophilia;the sensitivity rate to both amikacin and levofloxacin was 72.00%.Conclusion Among the non-fermenting bacteria cultured from patients with community-acquired pulmonary infection,the mucous Pseudomonas aeruginosa is the most common,followed by Acinetobacter,other non-fermenting bacteria,and Streptomonas maltophilia.In addition,the susceptibility of different strains to clinical antibacterial drugs is not the same,and clinical treatment should be combined with their susceptibility to antibacterial drugs for rational use.