重症监护病房非发酵菌感染分布特点及耐药情况分析  

Distribution and antimicrobial resistance of non-fermenters isolated from intensive care unit

作　　者：刘周[1] 管世鹤[1] 惠锦林[2] 陈礼文[1] 杨凯[1] 王成浩[1] 

机构地区：[1]合肥安徽医科大学第二附属医院检验科,230601 [2]合肥安徽医科大学第二附属医院感染管理办公室,230601

出　　处：《安徽医学》2013年第6期807-810,共4页Anhui Medical Journal

摘　　要：目的分析我院重症监护病房(ICU)非发酵菌感染分布及其耐药情况。方法对2009年1月至2011年12月,从我院ICU患者各类临床标本分离的非发酵菌株作体外药敏试验并对结果进行回顾性分析。药敏试验采用MIC法及K-B法,按CLSI 2010年版判断标准。结果共分离非发酵菌447株,其中前4位的分别是鲍曼不动杆菌207株(46.31%)、铜绿假单胞菌144株(32.21%)、嗜麦芽窄食单胞菌49株(10.96%)和伯克霍尔德菌36株(8.05%)。鲍曼不动杆菌仅对头孢哌酮/舒巴坦耐药率较低,为1.55%,对亚胺培南、美洛培南耐药率分别为49.61%和53.48%。铜绿假单胞菌对亚胺培南、美洛培南、阿米卡星及头孢哌酮/舒巴坦耐药率较低,分别为25.95%、29.01%、35.11%和0.76%,嗜麦芽窄食单胞菌及伯克霍尔德菌对多种抗菌药物天然耐药,对复方新诺明,喹诺酮类药物耐药率较低。推荐临床治疗使用。结论非发酵菌是重症监护病房感染常见病原菌,对常用抗菌药物耐药情况严重。应加强耐药性监测,为临床合理应用抗生素,防止院内感染提供依据。Objective To analyze the characteristics of infection distribution and antimicrobial resistance of non-fermenters isolated from intensive care unit （ICU） in our hospital. Methods Non-fermenters were separated and identified from the ICU patients who were hos- pitalized from January 2009 to December 2011. The antimierobial susceptibility testing （AST） of non-fermenters was determined lay K-B disk diffusion method and minimal inhibitory concentration （MIC） test, respectively. The AST was performed as recommended by CLSI 2010. Re- suits A total of 447 strains of non-fermenters were isolated from clinical specimens. The four top identified microorganisms were Acinetobacter baumannii （207 strain, 46.31%）, Pseudomonas aeruginosa （144 strain, 32.21%）, Stenotrophomonas mahophilia （49 strain, 10.96%） and Burkholderia （ 36 strain, 8.05% ）. The resistance rate of Aeinetobaeter baumannii to cefoperazone/sulbaetam was 1.55% while its resistance to Imipenem and Meropenem significantly increased to 49.61% and 53.48 %, respectively. Resistance of Pseudomonas aeruginosa to Imipenem, Meropenem, Amikaein and Cefoperazone/sulbactam was 25.95%, 29.01%, 35.11% and 0.76%, respectively. In contrast to the low resistance rates to sulfamethoxazole and quinolones, Stenotrophomonas maltophilia and Burkholderia had natural resistance to multiple antimicrobial drugs. Conclusion As prevalent pathogenic agents in ICU, non-fermenters have considerable resistance to commonly used antibiotics. Thus, period- ic surveillance is essential for the rational use of antibiotics and the effective prevention of nosocomial infections.

关 键 词：重症监护病房 非发酵菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]