非发酵革兰阴性杆菌临床分离状况与耐药性分析

目的了解某院非发酵革兰阴性（G-）杆菌的临床分离状况及常见菌株的耐药性,指导临床合理选用抗菌药.方法采用Microscan WalkAway-40全自动微生物鉴定仪及配套阴性菌药敏复合板对临床标本分离菌进行菌种鉴定与药敏试验;对头孢哌酮、头孢哌酮/舒巴坦的药敏检测,采用K-B琼脂扩散法.应用WHONET 5.0软件对数据进行统计分析.结果 2001年7月-2004年6月共检出非发酵菌712株,铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌居前3位,共占86.10%;标本来源主要为呼吸道分泌物、伤口分泌物、尿液,分别占74.16%,10.25%,7.44%;科室来源主要是呼吸科、传染病科、心胸外科,各占46.35%,13.90%,12.22%.居前3位的非发酵菌耐药性高,耐药谱不同.结论临床上非发酵G-杆菌以呼吸道、伤口和尿路感染常见,其耐药现象严重,宜根据药敏结果选用敏感抗菌药物治疗.

Analysis of clinical distribution and drug resistance of non-fermentative gram-negative bacilli

Objective To investigate the clinical distribution and drug resistance of non-fermentative gram-negative bacilli isolated from a hospital so as to guide the rational use of antirnicrobial agents in clinical patients. Methods Bacterial identification and antimicrobial susceptibility tests were performed by Microscan WalkAway-40 system and Negative Combo Panel Type 21, susceptibility tests of eefoperazone and cefoperazone/sulbactam were done by Kirby- Bauer method, and WHONET 5.0 was used for data statistic analysis. Results A total of 712 strains of non- fermentative bacteria were isolated between July 2001 and June 2004, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophornonas maltophilia accounted for 86.10% of them. The percentages of non-fermentative bacteria isolated from respiratory tract secretion, wound secretion and urine was 74.16%, 10.25% and 7.44% respectively; isolation rate from department of respiratory, infectious diseases and cardiothoradc surgery was 46.35 %, 13.90% and 12.22% respectively. Pseudornonas aeruginosa, Acinetobacter baumannii and Ste71otrophornonas nulltophilia had high antimicrobial resistance. Conclusion Infections of respiratory tract, wound and urinary tract caused by non-fermentative gram-negative bacilli are common in clinic, and drug resistance is serious, the drugs for the treatment of the infection caused by non-fermentative bacteria should be chosen according to the results of the antimicrobial susceptibility tests.