非发酵菌临床分布及耐药性分析

目的了解常德市第一人民医院非发酵菌感染的病原学分布及对常用抗生素的耐药情况,为临床提供诊断和治疗的依据。方法回顾性总结常德市第一人民医院2002年1月至2006年12月临床分离的非发酵菌分布特点及药敏结果。结果共检出非发酵菌904株,占分离细菌的18.3%。非发酵菌检出率较高的标本为痰液（27.0%）和伤口分泌物（24.9%）。分离率前4位的非发酵菌分别为铜绿假单胞菌（64.7%）、产碱假单胞菌（8.3%）、鲍曼不动杆菌（7.6%）及洋葱伯克霍尔德菌（3.1%）。主要非发酵菌对常用抗生素均有较严重的耐药性,耐药率最低的药物为碳青霉烯类抗生素美罗培南,头孢吡肟、左氧氟沙星、阿米卡星的耐药率相对较低。结论院内非发酵菌感染日趋严重,且呈现多重耐药倾向,值得进一步研究。临床应依据药敏结果优化选择抗生素,并采用合理的手段降低耐药率的发生。

Distribution and drug-resistance analysis of nonfermentative bacteria among clinical specimen

Objective To investigate the distribution and drug resistance among nonfermentative bacteria in clinical specimen.Methods The isolated bacteria were identified and antimicrobial susceptibility was tested from January 2002 to December 2006.Results Totally 904 strains of nonfermentative bacteria were isolated from the 4938 pathogenic strains（isolation rate =18.3%）.The positive rates of nonfermentative bacteria isolated from the sputum（27.0%）and secretions（24.9%）were higher.The most common pathogens were Pseudomonas aeruginosa（64.7%）,Pseudomonas alcaligenes（8.3%）,Acinetobacter baumanii（7.6%）and Burkholderia cepacia（3.1%）.Various resistance to all detected antibiotics was found among the nonfermentative bacteria isolated.The drug resistance was lower to the following antibiotics：meropenem,cefepime,levofloxacin,and amikacin.Conclusion More and more infection cases by nonfermentative bacteria were discovered and multi-drug resistance was presented by these bacteria.Proper antibiotics should be selected according to antibiotic sensitivity tests for improving the curing rates of infection.