1998-2005年我院临床分离非发酵革兰阴性杆菌耐药性分析

目的了解1998—2005年我院临床分离非发酵革兰阴性杆菌的分布和耐药性。方法MicroScan WalkAway-40全自动微生物鉴定和药敏系统从我院临床标本中分离的12700株非发酵革兰阴性杆菌进行鉴定和药敏试验。结果非发酵革兰阴性杆菌前4位依次是铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌和洛菲不动杆菌。非发酵苇兰阴性杆菌对11种抗菌药的耐药率均呈上升趋势，尤其是铜绿假单胞菌对头孢他啶、头孢吡肟、亚胺培南、庆大霉索和妥布霉索，鲍曼不动杆菌对亚胺培南耐药率上升明显。洛菲不动杆菌耐药率仍很低。嗜麦芽窄食单胞菌对12种常用抗菌药物呈现多重耐药，除对环丙沙星和复方磺胺甲嗯唑耐药率较低外，其余均在42．9％～100％。结论铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽窄食单胞菌足多重耐药且耐药率高的病原菌，应根据药敏试验结果选用抗菌药物。

Analysis on antibiotics resistance of nonfermenting gram-negative bacilli isolated from our hospital during 1998 and 2005

Objective To analyze the distribution and antibiotic resistance of nonfermenting gram-negative bacilli from 1998 to 2005. Methods A total of 12 700 strains of nonfermenting gram-negative bacilli isolated from West China Hospital were included in this analysis. Bacterial identification and antibiotic susceptibility testing were carried out using the MicroScan WalkAway 40 system. Results The most predominant nonfermenting gram-negative isolates were Pseudomonas aeruginosa, Acinetobacter baurnannii, Stenotrophomonas rnaltophilia and Acinetobacter lwoffi. From 1998 to 2005, the resistance rates of these isolates to 11 antibiotics increased, especially P. aeruginosa to ceftazidime, cefepime, imipenem, gentamicin and tobramycin. The resistance of A. baurnannii to imipenem increased obviously. The resistance rate of A. lwoffi was still very low. S. rnaltophilia was multi-drug resistant. The isolates were highly resistant to the antimicrobial agents tested with resistance rate from 42. 9% to 100% except eiprofloxacin and trimethoprim-sulfamethoxazole. Conclusions P. aeruginosa, A. baumannii and S. maltophilia are multi-resistant and highly resistant pathogens. Antimieroblal therapy should be decided according to the results of susceptibility testing.