ICU医院感染非发酵革兰阴性菌的分布与耐药性研究  

Distribution and antimicrobial resistance of nonfermentative gram-negative bacilli causing nosocomial infection in ICU

作　　者：刘传江[1] 杨家宏 周凤英[1] 周光宏[1] 胡静[1] 

机构地区：[1]麻城市人民医院检验科,湖北麻城438300 [2]广水市第一人民医院检验科,湖北广水432700

出　　处：《中华医院感染学杂志》2015年第23期5314-5316,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(30214078)

摘　　要：目的研究重症监护病房(ICU)医院感染最常见的3种非发酵革兰阴性菌感染部位及病原菌对抗菌药物的耐药性,为临床医师选择合适的抗菌药物进行抗感染治疗提供实验室参考指南。方法 279株非发酵革兰阴性菌来源于2012年1月-2013年6月医院ICU患者感染性标本,菌株鉴定严格按《全国临床检验操作规程》中的临床微生物检验规范进行试验操作,采用K-B法进行药敏试验,数据采用WHONET 5.5软件进行统计分析。结果 ICU分离的279株非发酵革兰阴性菌中铜绿假单胞菌检出115株占41.2%,鲍氏不动杆菌108株占38.7%,嗜麦芽寡养单胞菌48株占17.2%;铜绿假单胞菌和鲍氏不动杆菌对环丙沙星耐药率最高,分别达到61.7%和65.7%。结论医院应采取强制性干预措施,提高临床医师的抗菌药物处方水平,改变医院内非发酵革兰阴性菌耐药性快速增长的不良局面。OBJECTIVE To understand the infection sites and the antimierobial resistance of three species of nonfer- mentative gram-negative bacilli causing nosocomial infection in intensive care unit （ICU） and offer the experimental evidence for clinical anti-infective treatment. METHODS Infective samples from ICU from Jan. 2012 to Jun. 2013 were collected to perform bacterial isolation, culture and identification referring to National Guide to Clinical Labo- ratory Procedures. API identification cards （bioM6rieux） were used to identify the strains. The susceptibility tes- ting was performed by K-B method. The resistance results were assessed according to the newest CLSI break- points. The WHONET 5.5 software was used to analyze the data. RESULTS Among 279 nonfermenters, 115 Pseudomonas aeruginosa , 108 Acinetobacter baumannii , 48 Stenotrophomonas maltophilia and the others accoun- ted for 41.2%, 38.7% , 17.2 % and 2.9 % , respectively. Pseudomonas aeruginosa and Acinetobacter baumannii had the highest resistance to Ciprofloxacin, reaching up to 61.7% and 65.7%, respectively. CONCLUSION The mandatory intervention should be adopted＇to raise the level of clinical prescription and restrain the rapidly increas- ing tendency of antimicrobial resistance of nonfermentative gram-negative bacilli.

关 键 词：非发酵革兰阴性菌 铜绿假单胞菌 鲍氏不动杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]