非发酵革兰阴性杆菌的分布与耐药特性研究  

Study on distribution and characteristic of drug resistance in non-fermentation gram-negative bacilli

作　　者：闫玲[1] 马萍[2] 邓丽华[2] 丁爽[2] 侯静[2] 

机构地区：[1]徐州医学院,江苏徐州221004 [2]徐州医学院附属医院,江苏徐州221002

出　　处：《现代预防医学》2014年第15期2822-2824,2851,共4页Modern Preventive Medicine

摘　　要：目的了解附属医院临床分离非发酵革兰阴性杆菌的分布情况及耐药特点。方法采用BD PhoenixTM100全自动微生物鉴定系统及配套试剂对临床分离到的非发酵革兰阴性菌进行鉴定与药敏试验,WHONET5.4软件进行统计分析。结果 2012年1月-2013年1月从附属医院分离到非发酵革兰阴性杆菌872株,前四位分别是醋酸钙/鲍曼复合不动杆菌、铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽窄食单胞菌。非发酵菌感染的部位主要是呼吸道,主要分布于ICU。醋酸钙/鲍曼复合不动杆菌对美罗培南、阿米卡星耐药率较低,但耐药率超过50%;鲍曼不动杆菌对哌拉西林/他唑巴坦耐药率较低,为71.2%;铜绿假单胞菌对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、美罗培南和阿米卡星的耐药率均低于50%。结论非发酵革兰阴性杆菌耐药情况严峻,尤以不动杆菌为主,临床应加强细菌耐药的监测,合理使用抗生素,以有效控制耐药菌株的产生。Objective To investigate the clinical distribution and characteristic of drug resistance of non-fermentation gram-negative bacilli isolated from patients in the affiliated hospital. Methods Using microbial identification system PhoenixTM 100 and supplementary reagents of BD company, identification and drug sensitivity tests were performed. We made statistical analysis with software WHONETS.4. Results 872 strains of non-fermentation gram-negative bacilli were isolated, and Acinetobacter baumanniicalcoaceticus complex was the highest. Respiratory tract was the main infection site of non-fermentation bacilli, and its distribution was mainly in ICU. Resistance rates of Acinetobacter baumanniicaleoaceticus complex to meropenem and amikacin were lower than other antimicrobial drugs, but still over 50%; Resistance rate of Acinetobacter baumannii to piperacillin/tazobactam was lower, and that was 71.2%; Resistance rates of Psedomona aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, imipenem, meropenem, amikacin were all lower than 50%. Conclusion Drug resistance of non-fermentation gram-negative bacilli is serious, particularly in acinetobacter. To control the development of drug resistance, we should strengthen surveillance of drug resistance and use antibiotics more reasonably.

关 键 词：非发酵革兰阴性杆菌 耐药率 不动杆菌 

分 类 号：R117[医药卫生—公共卫生与预防医学]