无菌体液中非发酵革兰阴性杆菌临床分布与耐药性研究  

Clinical distribution and drug resistance of non-fermenting gram-negative bacilli isolated from sterile body fluids

作　　者：汪红[1] 宁长秀[1] 杭亚平[1] 钟桥石[1] 胡晓彦[1] 章白苓[1] 贾坤如[1] 胡龙华[1] 

机构地区：[1]南昌大学第二附属医院检验科,江西南昌330006

出　　处：《中华医院感染学杂志》2015年第5期1025-1027,共3页Chinese Journal of Nosocomiology

基　　金：江西省自然科学基金资助项目(20132BAB205062)

摘　　要：目的了解患者无菌体液中鲍氏不动杆菌和铜绿假单胞菌的临床分布及其耐药性,以指导临床合理使用抗菌药物。方法回顾性分析医院2012年1-12月分离自患者无菌体液中的鲍氏不动杆菌、铜绿假单胞菌的药敏试验结果,采用K-B法进行药敏试验,WHONET 5.5软件进行药敏数据分析。结果共检出鲍氏不动杆菌67株和铜绿假单胞菌55株,均主要来源于血液标本,分别占70.1%和56.4%;科室分布中鲍氏不动杆菌以ICU为主,占56.7%,而铜绿假单胞菌则主要分布在外科,占56.4%;多药耐药鲍氏不动杆菌和铜绿假单胞菌的检出率分别为70.1%和18.2%;鲍氏不动杆菌对9种常用抗菌药物的耐药率>50.0%,耐药率最低者为头孢哌酮/舒巴坦,为22.7%;铜绿假单胞菌对10种抗菌药物的耐药率均<30.0%,其中对阿米卡星耐药率最低,为5.6%;两者比较对共同测试的9种抗菌药物耐药率差异均有统计学意义(P<0.05)。结论无菌体液分离出的两种常见非发酵革兰阴性杆菌中,鲍氏不动杆菌耐药及多药耐药性均非常严重,而铜绿假单胞菌则对临床常用抗菌药物均非常敏感,可用于经验抗感染治疗。OBJECTIVE To investigate the clinical distribution and drug resistance of Acinetobacter baumannii and Pseudomonas aeruginosa isolated from the sterile body fluids of patients so as to provide guidance for reasonable clinical use of antibiotics .METHODS From Jan 2012 to Dec 2012 ,the results of drug susceptibility testings for the A .baumannii and P .aeruginosa strains that were isolated from the patients＇sterile body fluids were retrospectively analyzed ,the drug susceptibility testings were performed by using K‐B method ,and the drug susceptibility data were analyzed with the use of WHONET 5 .5 software .RESULTS A total of 67 strains of A .baumannii and 55 strains of P .aeruginosa have been isolated ,70 .1% of the A .baumannii strains were isolated from the blood speci‐mens ,and 56 .4% of the P .aeruginosa strains were isolated from the blood specimens .As for the distribution in the departments ,56 .7% of the A .baumannii strains were isolated from the ICU ,while 56 .4% of the P .aerugi‐nosa strains were isolated from the surgery department .The detection rates of multidrug‐resistant A .baumannii and P .aeruginosa were 70 .1% and 18 .2% ,respectively .The drug resistance rate of the A .baumannii to 9 com‐monly used antibiotics was more than 50 .0% ,and the drug resistance rate to cefoperazone‐sulbactam was the low‐est （22 .7% ） .The drug resistance rate of the P .aeruginosa to 10 antibiotics was less than 30 .0% ,and the drug resistance rate to amikacin was the lowest （5 .6% ）;there was significant difference in the drug resistance rate to the common tested antibiotics between the two （P〈 0 .05） .CONCLUSION Of the two most common species of non‐fermenting gram‐negative bacilli isolated from the sterile body fluids , the A .baumannii is highly drug‐resistant and multidrug‐resistant ,while the P .aeruginosa is highly sensitive to the commonly used antibiotics , which can be used for empirical treatment of infections .

关 键 词：无菌体液 鲍氏不动杆菌 铜绿假单胞菌 临床分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]