2015-2017年ICU非发酵菌分布及耐药性分析  

Analysis of distribution and drug resistance of non-fermenting bacteria in ICU during 2015-2017

作　　者：王毅[1] 李晓鹏[1] 于湘友[1] WANG Yi;LI Xiao peng;YU Xiang you(Department of Critical Care Medicine,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学第一附属医院重症医学科,新疆乌鲁木齐830054

出　　处：《新疆医学》2019年第3期213-217,共5页Xinjiang Medical Journal

基　　金：国家自然科学基金(基金项目:81160232)

摘　　要：目的了解ICU非发酵菌分布及耐药性特点,为临床治疗提供依据。方法 2015年-2017年综合ICU临床分离非发酵细菌1149株,采用VITEK-2行菌种鉴定,按CHINET统一方案行药敏试验。结果 1149株临床分离的非发酵菌中,鲍曼不动杆菌471株,占41.0%;铜绿假单胞菌388株,占33.8%;洋葱伯克霍尔德氏菌221株,占19.2%;嗜麦芽窄食单胞菌69株,占6.0%。常见非发酵菌对常见头孢菌素类抗菌药物均有耐药。鲍曼不动杆菌三年中对头孢哌酮舒巴坦的敏感率均大于50%,对碳青霉烯类的敏感率小于35%。铜绿假单胞菌对头孢哌酮舒巴坦的敏感率均大于70%,对哌拉西林他唑巴坦钠的敏感率大于40%,对碳青霉烯类的敏感率大于50%。洋葱伯克霍尔德氏菌对哌拉西林他唑巴坦钠及美罗培南的敏感性均大于70%。嗜麦芽窄食单胞菌对头胞哌酮舒巴坦的敏感性大于60%。鲍曼不动杆菌和铜绿假单胞菌对碳青霉烯类抗菌药物的耐药率仍然很高,鲍曼不动杆菌较铜绿假单胞菌耐药率要高,且有增高趋势。结论 ICU非发酵细菌耐药问题仍旧严重,主动早期筛查并获得本地细菌流行病学,有助于指导临床早期防治。Objective To understand the distribution and drug resistance characteristics of non-fermenting bacteria in ICU,and to provide the basis for clinical treatment.Methods From 2015 to 2017,1149 strains of non-fermentable bacteria were clinically isolated from the ICU,identified by vitek-2 strain,and according to the unified scheme of CHINET to conducted drug sensitivity test.Result Among the 1,149 clinical isolates,471 strains of acinetobacter baumannii were isolated,which accounted for 41.0%.There were 388 pseudomonas aeruginosa strains,which accounted for 33.8%.There were 221 strains of burkholderia,which accounted for 19.2%.There were 69 strains of stenotrophomonas maltophilia,which accounted for 6.0%.Non-fermentable bacteria were resistant to common cephalosporins.The sensitivity of acinetobacter baumannii to cefoperazone sulbactam was more than 50% and less than 35% for carbapenems in three years.The sensitivity rate of pseudomonas aeruginosa to cefoperazone sulbactam was more than 70%,that to piperazirin-tarazobactam was more than 40%,and that to carbapenems was more than 50%.The susceptibility of burkholderia to piperacillin,tazobactam sodium and meropenem was greater than 70%.The sensitivity of coperazone sulbactam in stenotrophomonas maltophilia was greater than 60%.The drug resistance rate of acinetobacter baumannii and pseudomonas aeruginosa against carbapenems is still very high.Conclusion The problem of non-fermentative bacterial resistance is still serious in ICU,and active early screening and local bacterial epidemiology can help guide clinical early prevention and treatment.

关 键 词：医院感染 重症医学科 耐药性 病原菌 

分 类 号：R713.4[医药卫生—妇产科学]