非发酵菌的临床检出情况及耐药分析

目的了解非发酵菌在临床标本中的检出情况及耐药特点。方法细菌鉴定和药敏试验用ATB Expression细菌鉴定仪及其配套试剂进行自动分析，对本院2002～2006年非发酵菌的年检出率、菌株种类及耐药特点进行分析。结果5年间从各类临床标本中共检出细菌6320株，其中非发酵菌874株，占13．8％。2002～2006年非发酵菌年检出率分别为10．1％、11．8％、9．9％、14．8％、20．5％。排名前3位的依次是铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽黄单胞菌。哌拉西林＋他唑巴坦、亚胺培南、妥布霉素、阿米卡星对铜绿假单胞菌和鲍曼不动杆菌的敏感性较高；产碱杆菌属和恶臭假单胞菌对亚胺培南和美罗培南均具有较高敏感性；复方新诺明和环丙沙星对嗜麦芽黄单胞菌的敏感性较高。结论非发酵菌在临床标本中的分离率近年呈逐渐上升趋势，对多种抗生素具有较高耐药率。应加强对抗生素敏感性的监测，避免各种高危因素，防止非发酵菌引起的医院感染。

Clinical distribution of nonfermenter and its antibiotic resistance

Objective To investigate the distribution of the nonfermenter （NF） and its antibiotic resistance. Methods The identification of bacteria and antibiotic susceptibility were performed by Microscan ATB-Expression Analyzer. The annual detective rate, types and antibiotic resistance of NF isolated from clinical samples between 2002 and 2006 in our hospital were retrospectively analyzed. Results NF accounted for 13.8% of a total of 6 320 strains from clinical settings in five years. The detective rate of NF was 10. 1%, 11. 8%, 9. 9%, 14. 8% and 20.5%, respectively in the year of 2002, 2003, 2004, 2005 and 2006. The three most common bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophmonas maltophilia. The susceptible rate of piperacillintazobactam, imipenem, tobramycin and amikacin to Pseudomonas aeruginosa and Acinetobacter baumannii was higher. The susceptible rate of imipenem and meropenem to Alcaligenes and Pseudomonas putica was higher too. The susceptible rate of sulfamethoxazole/trimethoprim and ciprofloxacin to Stenotrophmonas maltophilia was higher than the others. Conclusion The detective rate of NF isolated from clinical species is rising gradually in recent years. NF is high-resistant to a large varity of antibiotics. Prevention of NF induced hospital-acquired infection makes it necessary to place much emphasis on monitoring of antibiotic sensitivity and eliminating various high-risk factors.