下呼吸道分离的多药耐药非发酵菌临床分析  

Multidrug Resistant Non-fermentating Bacteria Isolated in Lower Respiratory Tract:A Clinical Analysis

作　　者：吴本权[1] 李雅茜[2] 黄静[1] 刘慧[1] 周宇麒[1] 饶宪[1] 张天托[1] 

机构地区：[1]中山大学附属第三医院呼吸内科,广东广州510630 [2]天河区中医院内科,广东广州510630

出　　处：《中华医院感染学杂志》2009年第20期2794-2796,共3页Chinese Journal of Nosocomiology

摘　　要：目的观察多药耐药(MDR)非发酵菌来源、细菌学特征、清除情况、复合感染以及其在下呼吸道内定植与感染的关系。方法从呼吸科病房自2008年1-9月的住院患者中采集到27株多药耐药非发酵菌进行耐药监测,收集多药耐药菌患者的临床资料进行统计学分析。结果在27株耐药非发酵菌中,25株多药耐药菌,2株广泛耐药(PDR)菌,74.1%来自重症监护病房,高于普通病房的25.9%(2χ=12.519,P=0.001),3种细菌完全清除率44.4%;在复合感染的细菌中,金黄色葡萄球菌占29.6%,白色假丝酵母菌占25.9%;3种细菌病死率分别是鲍氏不动杆菌23.1%、铜绿假单胞菌37.5%、嗜麦芽寡养单胞菌67.5%(χ2=3.346,P>0.05)。结论多药耐药非发酵菌主要来源于重症监护病房,清除率低,易发生复合感染,在一定程度上影响患者的转归。OBJECTIVE To observe the source, characteristic, clearance rates, and multi-infection of multi-drug resistant（MDR） non-fermenting bacterial and the relationship between colonization and infection in lower respiratory tract. METHODS Twenty-seven strains of MDR non-fermenting bacteria were isolated from the lower respiratory tract from Jan 2008 to Sep 2008 in respiratory ward and their clinical data were collected for statistically analysis. RESULTS Of 27 strains of non-fermenting Gram-negative bacteria, 25 strains were MDR bacteria,2 pandrug-resistant （PDR） bacteria. The isolated rate of 74.1% in intensive cure unit（ICU） was higher than 25.9 % in common ward（χ^2 = 12. 519, P=0. 001）. 44.4 % bacteria were cleaned out completely. In multiinfection bacteria, the proportion of Staphylococcus aureus was 29.6%, and Candida albicans was 25.9%. The mortality rate of the patients infected with Acinetobacter baumannii, Pseudomonas aeruginosa and Stenotrophomonas maltophilia were 23.1%, 37.5 % and 67.5 %, respectively. （χ^2= 3. 346, P〉0.05）. CONCLUSIONS The MDR non-fermenting bacteria are mostly isolated in ICU with lower bacterial clearance. It predisposes patients to co-infection and may influence their outcome in some degree.

关 键 词：多药耐药 非发酵菌 定植 感染 

分 类 号：R978.1[医药卫生—药品]