下呼吸道非发酵菌的耐药性分析

目的了解医院住院患者下呼吸道常见非发酵菌的分离情况和耐药特点,为临床合理应用抗菌药物提供依据。方法细菌鉴定采用法国生物梅里埃公司的鉴定条,药敏试验采用K-B纸片扩散法,应用WHONET53软件统计铜绿假单胞菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌的耐药率。结果铜绿假单胞菌对阿米卡星、亚胺培南、头孢哌酮/舒巴坦的耐药率均<20.0%;鲍氏不动杆菌对亚胺培南的耐药率最低为4.8%,其次为头孢哌酮/舒巴坦耐药率为7.3%,嗜麦芽寡养单胞菌对头孢哌酮/舒巴坦、替卡西林/克拉维酸、哌拉西林/他唑巴坦耐药率最低,分别为0、2.7%、10.8%。结论下呼吸道感染病原菌中非发酵菌所占比例越来越大,为减少医源性感染,应合理选用抗菌药物,对提高治愈率至关重要。

Antimicrobial Resistance of Nonfermentative Bacteria in Lower Respiratory Tract Infection

OBJECTIVE To investigate the epidemic situation of nonfermentative bacteria in lower respiratory tract infection and guide rational use of antimicrobials.METHODS API system was applied for bacterial identification.K-B disk diffuse method was used in susceptibility testing.WHONET 5.3 software was used for data analysis.Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia isolates were included in this study.RESULTS Less than 20% of P.aeruginosa isolates were resistant to amikacin,imipenem or cefoperazone/sulbactam.For A.baumannii,the most active compounds tested were imipenem and cefoperazone/sulbactam with resistance rates of 4.8% and 7.3%,respectively.26.6% And 27.4% of A.baumannii isolates were resistant to piperacillin/tazobactam and ticarcillin/clavulanic acid.The resistance rate of S.maltophilia to cefoperazone/sulbactam,ticarcillin/clavulanic acid and piperacillin/tazobactam was 0,2.7% and 10.8%,respectively.CONCLUSIONS The isolation rate of nonfermenters is increasing in the lower respiratory tract infection,and the ways to improve the cure rate are to avert nosocomial infection and choose antimicrobials properly.