住院结核病患者铜绿假单胞菌和鲍曼不动杆菌的检出率及药物敏感性分析  

Detection rates and drug sensitivities of Pseudomonas aeruginosa and Acinetobacter baumannii in tuberculosis patients

作　　者：潘美玉[1] 吴龙章[1] 苏碧仪[1] 

机构地区：[1]广州市胸科医院检验科,510095

出　　处：《中国防痨杂志》2014年第7期576-578,共3页Chinese Journal of Antituberculosis

摘　　要：目的 了解结核病患者铜绿假单胞菌和鲍曼不动杆菌的检出率及药物敏感性试验结果，为探讨合理使用抗生素和控制医院感染提供依据。 方法 根据《全国临床检验操作规程》，收集广州市胸科医院2011年1月至2013年8月临床住院结核病患者共6493例的送检标本，标本包括痰液、支气管纤维镜冲洗液、胸或腹腔积液、伤口分泌物、血液等。以痰液标本为主，占77.91%（5059/6493）；支气管冲洗液次之，占13.52%（878/6493），其他标本占8.56%（556/6493）。应用PHOENIX-100全自动微生物分析仪对细菌进行菌群鉴定和临床常用抗生素的药物敏感性试验。结果 6493例标本共分离出3612株临床分离株，其中铜绿假单胞菌985例，占总微生物的27.27%（985/3612）；鲍曼不动杆菌324例，占8.97%（324/3612）。其中铜绿假单胞菌对多黏菌素的敏感率达100.00%（985/985）、妥布霉素敏感率也在94.52%（931/985），对氨苄西林-舒巴坦和头孢唑啉的耐药率均为99.39%（979/985）。鲍曼不动杆菌除了对多黏菌素高度敏感（100.00%,324/324）外，对其余常用抗生素均有不同程度耐药。 结论 铜绿假单胞菌和鲍曼不动杆菌对临床多种抗生素呈现耐受性，因此应根据药物敏感性试验结果合理选择抗生素，避免耐药菌株的产生。Objective To understand the detection rates and the drug sensitivities of Pseudomonas aeruginosa and Acinetobacter baumannii in tuberculosis （TB） patients, to provide the basis for rational use of antibiotics and control of nosocomial infection. Methods According to the National clinical laboratory operating procedures, 6493 specimens （including 5059 sputa, 878 fiberoptic bronchoscopy lavage fluid （FBLF）, and 556 thoracic or abdominal cavity effusion, wound secretions, blood etc.） were collected from clinical laboratory in the Guangzhou Chest Hospital from January in 2011 to August in 2013,and then the bacteria were identified and performed the drug sensitivity test by PHOENIX-100 automatic microorganism analyzer. Results There were 3612 strains isolated from 6493 specimens, including 985 （27.27%） Pseudomonas aeruginosa and 324 （8.97%） Acinetobacter baumannii. Of 985 Pseudomonas aeruginosa isolates, 100.00% were sensitive to polymyxin, 94.52%（931/985）were sensitive to tobramycin, 99.39% （979/985） were resistance to ampicillin/Shubatan, and cefazolin. 100.00%（324/324）Acinetobacter baumannii isolates were highly sensitive to polymyxin, and different degrees of resistance to other antibiotics. Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates were resistance to various antibiotics. Should be reasonable to select antibiotics according to the drug sensitivity test results, to avoid drug-resistant strains.

关 键 词：结核 假单胞菌 铜绿 鲍氏不动杆菌 微生物敏感性试验 

分 类 号：R378[医药卫生—病原生物学]