住院患者非发酵革兰阴性杆菌感染调查  

Investigation and analysis of the infection of non-fermenting gramnegative bacteria in hospitalized patients

作　　者：赵蓬波[1] 鞠晓红[2] 李瑶[2] 王月华[2] 

机构地区：[1]吉林省人民医院检验科,吉林长春132000 [2]吉林医药学院病原教研室,吉林吉林132013

出　　处：《现代预防医学》2016年第16期3040-3043,共4页Modern Preventive Medicine

基　　金：江苏省检验医学重点实验室开放基金项目(项目编号:JSKLM-2014-016)

摘　　要：目的探讨住院患者非发酵革兰阴性杆菌感染的临床特征,为感染治疗及预防控制提供实验依据。方法对2013年1月至2014年12月住院患者感染的非发酵革兰阴性杆菌进行回顾性分析。结果共分离非发酵革兰阴性杆菌1 595株,占总检出率的16.96%。感染部位以下呼吸道为主(63.95%),其次是伤口创面(11.03%)和上呼吸道(10.53%)。主要检出菌是铜绿假单胞菌(41.25%)、鲍曼不动杆菌(28.90%)和嗜麦芽窄食单胞菌(15.60%)。鲍曼不动杆菌耐药严重,耐药率低于30%的药物仅有多黏菌素B(1.08%)、阿米卡星(28.20%)和亚胺培南(29.07%);铜绿假单胞菌耐药率较高的药物有头孢曲松(98.02%)、头孢噻肟(88.30%)和复方新诺明(60.94%),对其他监测药物均较敏感。结论铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽窄食单胞菌是非发酵菌常见菌种,以呼吸道感染为主,存在不同程度耐药性,应加强耐药菌监测,指导临床合理用药。Objective The study aimed to investigate the clinical characteristics of non-fermenting gram-negative bacteria among hospitalized patients, so as to provide an experimental reference for the treatment and prevention of infections.Methods Retrospective analysis was performed on data of non-fermenting gram-negative bacteria infection among patients hospitalized at our hospital between January of 2013 and December of 2014. Results A total of 1595 strains of non-fermenting gram-negative bacteria were isolated, with a positive rate of 16.96%. The infections were mainly occurred in the lower respiratory tract（63.95%）, followed by wound（11.03%） and upper respiratory tract（10.53%）. The main isolated pathogens were Pseudomonas aeruginosa（41.25%）, Acinetobacter baumannii（28.90%）, and Stenotrophomonas maltophilia（15.60%）. The A. baumannii exhibited strong drug resistance, and were lower than 30% resistant only against polymyxin B（1.08%）, amikacin（28.20%）, and imipenem（29.07%）. P. aeruginosa were strongly resistant against ceftriaxone（98.02%）,cefotaxime（88.30%）, and sulfamethoxazole/trimethopr（60.94%）, but were sensitive to most other antibiotics. Conclusion P.aeruginosa, A. baumannii, and S. maltophilia are among the most common non-fermenting pathogens and mainly infect the respiratory tract. The pathogens exhibit different levels of drug resistance. Monitoring of drug-resistance bacteria should be strengthened to guide rational clinical use of antibiotics.

关 键 词：非发酵菌 革兰阴性杆菌 耐药性 抗菌药物 医院感染 

分 类 号：R378[医药卫生—病原生物学]