医院感染中常见非发酵菌的临床分布及耐药性分析

摘要

目的:研究我院院内感染中非发酵菌的临床分布及其对抗菌药物的耐药情况,为临床合理使用抗生素提供参考.方法:对我院2013-01～2015-12送检的患者标本进行培养、鉴定和药敏试验,利用WHONET 5.6软件统计分析主要的非发酵菌及其药敏结果.结果:共检出非发酵菌3 533株,位居前3位的依次为鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌,分别占检出菌的53.04％、33.29％和10.33％;分离出的非发酵菌主要来源于痰标本(67.39％),且主要集中分布于ICU、急诊科、呼吸内科和神经外科.药敏结果显示,鲍曼不动杆菌、铜绿假单胞菌主要对多黏菌素B和头孢哌酮/舒巴坦敏感,嗜麦芽窄食单胞菌主要对米诺环素和左氧氟沙星敏感.结论:近3年我院非发酵菌主要分离自下呼吸道标本,且对多种抗生素高度耐药;需定时分析总结非发酵菌的分布和耐药情况,以预防和控制院内感染.%Objective:To investigate the clinical distribution and antimicrobial resistance of non-fermentative bacteria causing nosocomial infection in this hospital,and to provide guidance for clinical rational use of antimicrobial agents.Methods:Specimens from patients in this hospital between January 2013 and December 2015 were cultured,identified and performed antimicrobial susceptibility testing,main non-fermentative bacteria and antimicrobial susceptibility results were analyzed statistically by WHONET 5.6 software.Results:A total of 3 533 strains of non-fermentative bacteria were isolated,in which Acinetobacter baumannii,pseudomonas aeruginosa and stenotrophomonas maltophilia accounted for 53.04％,33.29 ％ and 10.33 ％,respectively.Non-fermentative bacteria were mainly isolated from sputum (67.39 ％) and were distributed in the department of intensive care unit (ICU),emergency,respiratory medicine and neurosurgery.The susceptibility results showed that Acinetobacter baumannii and pseudomonas aeruginosa were mainly sensitive to polymyxin B and cefoperazone-sulbactam,while stenotrophomonas maltophilia were highly sensitive to minocycline and levofloxacin.Conclusion:Non-fermentative bacteria are mainly isolated from lower respiratory tract specimens in recent 3 years,and are highly resistant to multiple antimicrobial agents.Therefore,regular analysis on distribution and antimicrobial resistance of non-fermentative bacteria is helpful for the prevention and control of nosocomial infection.