ICU分离的166株洋葱伯克霍尔德菌耐药性分析

目的调查某院重症监护室（ICU）洋葱伯克霍尔德菌的分离及耐药情况。方法回顾性分析该院ICU 2008 年1月-2009 年12月检出的洋葱伯克霍尔德菌资料。结果调查期间ICU送检的各类标本共分离洋葱伯克霍尔德菌166株,占总检出菌株数的23.82%（166/697）；其中痰和咽拭子分离153株，中段尿9株，血管导管液2株，引流液2 株。药敏结果显示，洋葱伯克霍尔德菌对头孢唑林、亚胺培南、氨苄西林/舒巴坦、庆大霉素、妥布霉素、阿米卡星耐药率高，达98.19%～100.00%；对第三代头孢菌素（头孢他啶）的耐药率较低（11.45%），对哌拉西林/他唑巴坦的耐药率最低（10.84%）。结论洋葱伯克霍尔德菌在该院ICU分离率较高，对临床常用的抗菌药物有极高的耐药性,临床医生应积极开展病原学检查，注意正确、合理使用抗菌药物。

Drug resistance of 166 strains of Burkholderia cepacia isolated from an intensive care unit

Objective To investigate the distribution and drug-resistance of Burkholderia cepacia isolated from an intensive care unit （ICU） in a hospital. Methods Burkholderia cepacia isolated from ICU in a hospital between January 2008 and December 2009 were analysed retrospectively . Results 166 strains of Burkholderia cepacia were isolated,which accounting for 23. 82% （166/697） of the total isolated strain, 153 of which were isolated from sputum and throat swabs, 9 from urine, 2 from fluid in blood catheter,2 from drainage fluid. Antimicrobial susceptibility test showed that Burkholderia cepacia had high resistance to antimicrobial agents including cefazolin, imipenem, ampicillin/sulbactam, gentamicin, tobramycin, and amikacin, which were up to 98. 19% - 100. 00 % ; and Burkholderia cepacia had low resistant rate （11.45%） to the third-generation cephalosporins （ceftazidime）. The lowest re- sistant rate （10. 84%） was to piperacillin/tazobactam. Conclusion The isolation of Burkholderia cepacia is high in ICU in this hospital , and resistance to commonly used antimicrobial agents is high , clinicians should perform pathogenic detection, and use antimicrobial agents rationally.