临床常见非发酵菌的分布特点及其耐药性分析  

The characteristics of distribution and drug resistance analysis of clinical common non-fermentative bacteria

作　　者：于海涛 孙建芝[2] 李杰[3] 苏维奇[4] 

机构地区：[1]烟台龙矿中心医院检验科,山东龙口265700 [2]滨州医学院烟台附属医院检验科,山东烟台265000 [3]烟台毓璜顶医院检验中心,山东烟台264000 [4]青岛市市立医院检验科,山东青岛266011

出　　处：《中国实验诊断学》2013年第4期691-693,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解非发酵菌医院感染的临床分布特点及其耐药特性,为临床抗感染治疗提供指导。方法应用MicroScan WalkAway-96全自动细菌鉴定系统,对临床分离菌进行鉴定同时测定其对常用抗菌药物的MIC;收集非发酵菌医院感染病例资料,并分析其临床感染特点。结果共检出非发酵菌1276株,占革兰阴性杆菌的35.9%,其中鲍曼不动杆菌601株,占非发酵菌的47.1%、铜绿假单胞菌536株,占非发酵菌的42.0%;呼吸道是非发酵菌最常见的感染部位,其次为创面皮肤切口;病区分布主要见于ICU、呼吸科、烧伤科和神经内科;非发酵菌对大部分常用抗菌药物的耐药率为60%-80%,耐药率较低的抗菌药物有头孢哌酮/舒巴坦、美罗培南、亚胺培南和阿米卡星。结论非发酵菌的分离率高,临床分布广泛,多重耐药现象较为严重,相关部门应加强监测和管理。Objective Understanding clinical distribution characteristics and its resistance of non- fermentative bac- teria of nosocomial infection, and to provide guidance for clinical anti-infective therapy. Methods Application of Mi- croSc0n WalkAway-96 automatic bacteria[ identification system, simultaneous determination of the commonly used anti- microbial agents against clinical isolates were identified by MIC. Collect Nosoc0mial infections of non- fermentative,and analyze its clinical infection characteristics. Results There were non-fermentative bacteria 1276 strains, accounting for 35.9%o of gram negative bacilli,among them Bauman Acinetobacter strains 601,accounting for 47. 1%, Pseudomonas aeruginosa strains 536,accounting for 42%,The respiratory tract is the most common site of non fermentative bacteria infection, followed by wound skin incision. Ward distribution is mainly in the ICU, respiratory, burn unit, and the De- partment of Neurology. Non-fermentative bacteria resistance to most commonly used antibiotics was 60%-80% ,antibacterial drug resistance rate lower with Cefoperazone / sulbactam,meropenem,imipenem and Amikacin. Conclusion Separation of non-fermenting bacteria rate is high, clinical widely distributed, multi-drug resistance phenomenon is serious, the relevant departments should strengthen the monitoring and management.

关 键 词：非发酵菌 医院感染 耐药性 

分 类 号：R446.5[医药卫生—诊断学]