医院感染常见非发酵革兰阴性菌的临床分布和耐药性分析

目的了解非发酵菌在我院5年中的临床分布以及耐药情况。方法采用ATB细菌鉴定仪进行细菌鉴定,K-B纸片扩散法进行体外药敏试验。结果2000年1月~2004年12月我院共分离出非发酵菌875株,居前3位的非发酵菌分别是铜绿假单胞菌313株,鲍氏不动杆菌287株,嗜麦芽寡养单胞菌180株;药敏结果显示:铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率最低分别为17.6%和7.7%,而对头孢噻吩、头孢曲松和复方新诺明的耐药率最高,耐药率>80%;嗜麦芽寡养单胞菌对亚胺培南天然耐药,对其他大多数抗菌药物呈高度耐药,而复方新诺明对该菌非常敏感,耐药率为7.8%。结论非发酵菌对临床常用的抗菌药物有较高的耐药性,提醒临床在治疗非发酵菌感染时应根据实验室的药敏结果合理选用敏感的抗菌药物。

Drug Resistance and Clinical Distribution of Common Nonfermenters in Nosocomial Infection

OBJECTIVE To investigate the clinical distribution and drug resistance of the nonfermenters between 2000 and 2004 in our hospital. METHODS The bacteria were identified by ATB,drug resistance test was then performed by K-B method. RESULTS A total of 875 strains of nonfermentative Gram-negative bacteria were isolated from various clinical specimens during Jan 2000-Dec 2004.The dominant strains were Pseudomonas aeruginosa((313 strains)),Acinetobacter baumannii(287 strains) and Stenotrophomonas maltophilia(180 strains).They happened most commonly in the respiratory system.The positive rate from sputum and pharyngeal probe was 73.7% and 6.2%.The resistance rate of P.aeruginosa and A.baumannii to imipenem was the lowest,accounted for 17.6% and 7.7%.These nonfermenters were highly resistant to cefalotin,ceftriaxone and sulfamethoxazole/trimethoprim.The resistance rate of S.maltophilia to sulfamethoxazole/trimethoprim was lower than the others,the rate being 7.8%. CONCLUSIONS The drug resistance of nonfermenters to frequently-used antibacterials is higher.Due to the high resistant rates,the drugs should be chosen according to the result of the drug susceptibility test.