常见非发酵革兰阴性杆菌的分离及耐药性分析  

Resistance Analysis of Nonfermentative Gram-negative Bacilli

作　　者：路西春[1] 李力[1] 刘正祥[1] 李晓玲[1] 刘娜[1] 冉继华[1] 伏建峰[1] 

机构地区：[1]兰州军区乌鲁木齐总医院检验科,新疆乌鲁木齐830000

出　　处：《中华医院感染学杂志》2009年第11期1428-1430,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院常见非发酵革兰阴性杆菌的分离情况及耐药特点。方法细菌鉴定用VITEK全自动微生物鉴定仪,药敏试验用纸片琼脂扩散法。结果自2003年1月-2007年12月临床分离出的3069株革兰阴性杆菌中,铜绿假单胞菌871株、不动杆菌属655株、嗜麦芽寡养单胞菌279株;非发酵革兰阴性杆菌在各类标本细菌分离结果分析,以呼吸道标本痰分离率最高(66.3%),其次是分泌物(16.8%)、中段尿(10.0%);铜绿假单胞菌对亚胺培南、美罗培南敏感率较高,分别为75.2%和78.6%,其次是头孢吡肟(67.3%),头孢他啶(63.6%);不动杆菌属对氨曲南敏感率很低,为12.6%,对亚胺培南、美罗培南敏感率均>90.0%,其他多种抗菌药物的敏感率下降到<60.0%;嗜麦芽寡养单胞菌对复方新诺明、左氧氟沙星及米诺环素的敏感率分别为73.4%、86.2%、89.8%。结论非发酵革兰阴性杆菌的分离率及耐药率高,治疗该类细菌感染应根据临床分离株耐药性检测结果选用亚胺培南、美罗培南等敏感药物或联合用药,合理使用抗菌药物。OBJECTIVE To investigate the bacterial resistance of nonfermentatice gramnegative bacilli （NFGNB） in recent 5 years. METHODS The bacteria identification was done by VITEK Auto Microbe System and antimicrobial susceptibility tests were conducted by Kirby-Bauer method. RESULTS Among the 3069 strains of Gram-negative bacilli, 871 （28. 4% ） were Pseudomonas aeruginosa ; 655 （21. 4%） were acinetobacter spp： 279 （9.1%） were Stenotrophomonas maltophilia. Most of them were isolated from sputum（ 66. 3 %）, secretion （16.8 %） and urine （10. 0%）, respectively. The antibacterial resistance of P. aeruginosa was as followset imipenem （75. 2%）, meropenem（78.6%）, TMP-SMZ （4.6%）, levofloxacin（47.9%）, minocycline（33.9%）, piperacillin（51.7%）, piperacillin/tazobactam （ 56. 0 %）, ceftazidime （ 63. 6 %）, cefepime （ 67. 3 %）, gentamicin （ 37.2 % ）, ticarcillin- clavulanate（22.8 % ）, aztreonam （ 29. 3 % ）, and ciprofloxacin （ 63.4 % ） ; while the activity against Acinetobacter spp was to aztreonam（12.6%）, imipenem（96.9%）, meropenem（95.6%）, and to other 10 antibiotics （less than 60%）, and the activity against S. maltopbnilia was to TMP-SMZ （73. 4%）, levofloxacin （86. 2%）, and minocycline（89. 8%）. CONCLUSIONS Since the isolation and drug resistance rates of NFGNB are high, the combined antibiotics should be used to treat NFGNB infection, such as imipenem, meropenem and others which are sensitive to NFGNB.

关 键 词：假单胞菌属 不动杆菌属 嗜麦芽寡养单胞菌 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]