住院患者非发酵菌感染的临床特征及耐药性分析

目的]了解吉林市某医院住院患者非发酵菌感染临床分布及耐药性特点,为临床抗感染治疗提供依据。方法]收集2005年3月～2009年7月临床各类标本,常规培养鉴定细菌,K-B纸片扩散法进行药敏试验。结果]共检出细菌1063株,其中非发酵菌220株,占总检出数的20.70%,占革兰阴性杆菌的28.46%,以鲍曼不动杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌、洋葱伯克菌为主要病原菌,标本主要分布于下呼吸道(52.73%),其次是创面分泌物(32.73%)和穿刺引流液(4.55%),病区主要集中于烧伤外科(33.18%)和呼吸内科(20.91%)。铜绿假单胞菌和鲍曼不动杆菌耐药性严重,较敏感的药物有美罗培南、亚胺培南、左氧氟沙星、头孢吡肟和阿米卡星。结论]鲍曼不动杆菌和铜绿假单胞菌是该院最常见的非发酵菌,对多种抗菌药物存在耐药性,及时监测病原菌变化及耐药趋势对指导临床用药至关重要。

ANALYSIS ON CLINICAL DISTRIBUTION AND DRUG RESISTANCE OF NON-FERMENTING BACTERIUM IN HOSPITALIZED PATIENTS

Objective]To investigate the clinical distribution and drug resistance of non-fermenting bacterium isolated from our hospital and offer the basis for the treatment of bacteria infection.Methods]Antimicrobial susceptibility of non-fermenting bacterium isolated in various kinds of specimens from March 2005 to July 2009 was tested by kirby-bauer method..The distribution and drug resistance were analyzed.Results]Among 1 063 strains of Gram-negative bacterium,non-fermenting bacterium were 220 strains which accounted for 20.70% of all pathogenic bacteria and 28.46% of Gram-negative bacterium.There were mainly A.baumanii,P.aeruginosa,S.maltophilia and B.cepacia.The distribution of specimens came mainly from sputum(52.73%),wound secretions(32.73%)and drawing fluid(4.55%).They were gathered in burn ward(33.18%)and respiratory disease ward(20.91%).A.baumanii and P.aeruginosa were with severe drug resistence.They were susceptible to Meropenem,Imipenem,Levofloxacin,Cefepime and Amikacin.Conclusion]A.baumanii and P.aeruginosea are important non-fermenting bacteria causing nosocomial infection in our hospital and their drug resistance rate is very high.It is very important that we promptly monitor changes of pathogenic bacterial flora and their drug resistance tendency to clinical medication.