医院感染常见非发酵革兰阴性菌临床分布与耐药性分析.doc

# 论 著# 医院感染常见非发酵革兰阴性菌的 临床分布和耐药性分析 毛盛尧, 朱幼珠, 张 翊 ( 余姚市人民医院, 浙江余姚315400) 摘要: 目的 了解非发酵菌在我院5 年中的临床分布以及耐药情况。方法 采用ATB 细菌鉴定仪进行细菌鉴 定, K-B 纸片扩散法进行体外药敏试验。结果 2000 年1 月~ 2004 年12 月我院共分离出非发酵菌875 株, 居前 3 位的非发酵菌分别是铜绿假单胞菌313 株, 鲍氏不动杆菌287 株, 嗜麦芽寡养单胞菌180 株; 药敏结果显示: 铜 绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率最低分别为171 6%和71 7%, 而对头孢噻吩、头孢曲松和复方新 诺明的耐药率最高, 耐药率 80%; 嗜麦芽寡养单胞菌对亚胺培南天然耐药, 对其他大多数抗菌药物呈高度耐药, 而复方新诺明对该菌非常敏感, 耐药率为71 8%。结论 非发酵菌对临床常用的抗菌药物有较高的耐药性, 提醒 临床在治疗非发酵菌感染时应根据实验室的药敏结果合理选用敏感的抗菌药物。 关键词: 非发酵菌; 医院感染; 抗菌药物 中图分类号: R3781 99 文献标识码: A 文章编号: 1005-4529( 2006) 06- 0694- 03 收稿日期: 2005- 04- 05 ; 修回日期: 2005- 10- 09 Drug Resistance and Clinical Distribution of Common Nonfermenters in Nosocomial Infection MAO Sheng-yao, ZHU You-zhu, ZHANG Yi ( Peop lecs H osp t ial of Yuy ao , Yuy ao, Zhej iang 315400, China) Abstract: OBJECTIVE To investig ate the clinical distributio n and drug r esistance of the no nf erment er s betw een 2000 and 2004 in our hospital. METHODS T he bacter ia wer e identified by AT B, dr ug resistance test was then perfo rmed by K-B metho d. RESULTS A to tal of 875 strains of no nfermentative Gram- negat ive bacter ia w ere iso lated from v arious clinical specimens dur ing Jan 2000-Dec 2004. The dominant st rains wer e Ps eudomonas aeruginosa ( 313 st rains) , A cinetobacter baumannii ( 287 str ains) and Stenotr op homonas maltop hilia ( 180 str ains) . They happened mo st commo nly in the respirato ry sy stem. T he positiv e rate from sputum and phary ngeal pro be w as 731 7% and 61 2%. T he resistance rate o f P. aer uginosa and A . baumannii to imipenem was t he low est, accounted fo r 171 6% and 71 7%. These nonfermenters wer e hig hly resistant to cefalotin, ceftr iaxo ne and sulfamethox azo le/ trimetho pr im. The resistance r ate of S . malto p hilia to sulfametho x azo le/ t rimethopr im was low er than t he o ther s, the rate being 71 8%. CONCLUSIONS T he drug resistance o f no nfermenter s t o fr equentlyused antibact erials is higher. Due to the high resistant rates, the dr ug s shoul