ICU医院感染非发酵革兰阴性杆菌的耐药性  

Antimicrobial resistance of nonfermentative gram-negative bacilli causing nosocomial infection in ICU

作　　者：孙光成[1,2] 史莉[1,2] 

机构地区：[1]湖北医药学院附属襄阳医院检验科,湖北襄阳441000 [2]襄阳市第一人民医院检验科,湖北襄阳441000

出　　处：《中华医院感染学杂志》2012年第2期391-392,共2页Chinese Journal of Nosocomiology

摘　　要：目的了解ICU医院感染常见的3种非发酵革兰阴性杆菌对抗菌药物的耐药性,为临床医师抗感染治疗提供实验室依据。方法细菌培养严格按《全国临床检验操作规程》进行;菌株鉴定采用法国生物梅里埃公司生产的VITEK-32全自动细菌分析系统及鉴定卡进行;采用K-B法进行药敏试验,依据CLSI最新折点判读结果;数据处理应用WHONET5.4软件分析。结果 313株非发酵革兰阴性杆菌中,铜绿假单胞菌(PAE)占45.7%;鲍氏不动杆菌(ABA)占32.3%;嗜麦芽寡养单胞菌(PMA)占12.1%;其他非发酵革兰阴性杆菌占9.9%;3种细菌对14种常用抗菌药物已产生了严重的耐药性,PAE和ABA泛耐药株检出率分别为24.5%、26.7%。结论医院应采取有效的干预措施,遏制非发酵革兰阴性杆菌耐药性快速增长的不良趋势。OBJECTIVE To understand antimicrobial resistance of three species of nonfermentative gram-negative bacilli causing nosocomial infection in intensive care unit（ICU） to provide experimental evidence for clinical anti-infective treatment.METHODS Referring to National Guide to Clinical Laboratory Procedures,bacterial cultivation was carried out.The VITEK 32 system and identification cards（bioMérieux） were used to identify the strains.The susceptibility testing was performed by K-B method.The susceptibility testing results were assessed according to the latest version of CLSI breakpoints.The WHONET5.4 software was used to analyze the data.RESULTS Among 313 nonfermentive gram-negative bacilli isolates,Pseudomonas aeruginosa（PAE）,Acinetobacter baumannii（ABA）,Stenotrophomonas maltophilia（PMA） and others accounted for 45.7%,32.3%,12.1% and 9.9%,respectively.Serious antimicrobial resistance of 14 commonly used antibiotics had occurred in the three species of nonfermentative gram-negative bacilli.The isolating rates of pan-resistant PAE and ABA were 24.5% and 26.7%,respectively.CONCLUSION Effective intervention measures should be adopted to restrain the rapidly increasing tendency of antimicrobial resistance of nonfermentative gram-negative bacilli.

关 键 词：重症监护病房 医院感染 非发酵革兰阴性杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]