外科非发酵菌感染的临床分布与耐药性分析

目的了解医院外科非发酵菌的临床分离状况及常见菌株的耐药性,指导临床合理选用抗菌药物。方法分离出的非发酵菌采用VITEK-60 AMS细菌鉴定仪鉴定,用K-B法进行体外药敏试验。结果2002年1月-2005年12月共检出非发酵菌463株,其中铜绿假单胞菌最为常见（55.07%）,其次为鲍氏不动杆菌（20.52%）和嗜麦芽寡养单胞菌（11.88%）;标本来源主要为痰液、引流液、伤口分泌物,分别占31.97%、13.39%、12.31%;科室来源主要是SICU、器官移植外科、烧伤外科,各占28.08%、17.28%、12.10%。居前3位的非发酵菌耐药较为严重,且呈多重耐药性。结论外科非发酵菌以呼吸道、伤口感染常见,其耐药现象严重,宜根据药敏结果选用敏感抗菌药物治疗。

Clinical Distribution and Drug Resistance of Non-fermentative Bacilli in Surgery

OBJECTIVE To investigate the clinical distribution and drug resistance of non-fermentative bacilli isolated from department of surgery so as to guide the rational use of antibiotics.METHODS VITEK-60 AMS system and Kirby-Bauer method were used to identify the pathogenic bacilli and examine the antibiotic resistance.RESULTS A total of 463 strains of nonfermentative bacteria were isolated from Jan 2002 to Dec 2004,the most common pathogen was Pseudomonas aeruginosa(55.07%),the next were Acinetobacter baumannii(20.52%) and Stenotrophomonas maltophilia(11.88%).The samples were mainly sputum(31.97%),drainage(13.39%),and wound secretion(12.31%).Isolation rate from SICU,departments of organ transplantation and burn were 28.08%,17.28% and 12.10%,respectively.P.aeruginosa,A.baumannii and S.maltophilia had high and multi-drug resistance.CONCLUSIONS Infections of respiratory tract and wound caused by non-fermentative bacilli are common in surgical department,and drug resistance is serious.The drugs should be chosen according to the results of the antimicrobial susceptibility tests.