海南医学
海南醫學
해남의학
Hainan Medical Journal
2015年
18期
2778-2780
,共3页
非发酵菌%临床分布%耐药性%铜绿假单胞菌%鲍曼不动杆菌
非髮酵菌%臨床分佈%耐藥性%銅綠假單胞菌%鮑曼不動桿菌
비발효균%림상분포%내약성%동록가단포균%포만불동간균
Non-fermenting bacteria%Clinical distribution%Drug resistance%Pseudomonas aeruginosa%Aci-netobacter baumannii
目的：探讨非发酵菌的临床分布特征及耐药性。方法选取本院2011年3月到2014年2月临床细菌送检的8817份标本进行细菌鉴定，对非发酵菌的临床分布和组成以及耐药性与敏感率进行分析。结果8817份标本中分离出病菌1297株，其中非发酵菌378株，占29.14%。位居前4位的非发酵菌是铜绿假单胞菌(39.15%)、鲍曼不动杆菌(28.57%)、嗜麦芽窄食单胞菌(11.38%)、粪产碱杆菌(4.23%)；非发酵菌标本主要为痰液、伤口分泌物、尿液、血液，其主要分布在内一科、外二科、ICU、外一科；铜绿假单胞菌对美罗培南、亚胺培南、左氧氟沙星、头孢吡肟、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的总耐药率分别为12.16%、14.19%、12.84%、21.62%、13.51%、14.86%；鲍曼不动杆菌则分别为27.78%、23.15%、26.85%、28.70%、10.18%、27.78%。结论非发酵菌临床上多药耐药性发生率较高，患者用药时相关部门应加强病原学和耐药性监测，根据结果选择合理的抗菌药物，提高临床疗效。
目的：探討非髮酵菌的臨床分佈特徵及耐藥性。方法選取本院2011年3月到2014年2月臨床細菌送檢的8817份標本進行細菌鑒定，對非髮酵菌的臨床分佈和組成以及耐藥性與敏感率進行分析。結果8817份標本中分離齣病菌1297株，其中非髮酵菌378株，佔29.14%。位居前4位的非髮酵菌是銅綠假單胞菌(39.15%)、鮑曼不動桿菌(28.57%)、嗜麥芽窄食單胞菌(11.38%)、糞產堿桿菌(4.23%)；非髮酵菌標本主要為痰液、傷口分泌物、尿液、血液，其主要分佈在內一科、外二科、ICU、外一科；銅綠假單胞菌對美囉培南、亞胺培南、左氧氟沙星、頭孢吡肟、頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦的總耐藥率分彆為12.16%、14.19%、12.84%、21.62%、13.51%、14.86%；鮑曼不動桿菌則分彆為27.78%、23.15%、26.85%、28.70%、10.18%、27.78%。結論非髮酵菌臨床上多藥耐藥性髮生率較高，患者用藥時相關部門應加彊病原學和耐藥性鑑測，根據結果選擇閤理的抗菌藥物，提高臨床療效。
목적：탐토비발효균적림상분포특정급내약성。방법선취본원2011년3월도2014년2월림상세균송검적8817빈표본진행세균감정，대비발효균적림상분포화조성이급내약성여민감솔진행분석。결과8817빈표본중분리출병균1297주，기중비발효균378주，점29.14%。위거전4위적비발효균시동록가단포균(39.15%)、포만불동간균(28.57%)、기맥아착식단포균(11.38%)、분산감간균(4.23%)；비발효균표본주요위담액、상구분비물、뇨액、혈액，기주요분포재내일과、외이과、ICU、외일과；동록가단포균대미라배남、아알배남、좌양불사성、두포필우、두포고동/서파탄、고랍서림/타서파탄적총내약솔분별위12.16%、14.19%、12.84%、21.62%、13.51%、14.86%；포만불동간균칙분별위27.78%、23.15%、26.85%、28.70%、10.18%、27.78%。결론비발효균림상상다약내약성발생솔교고，환자용약시상관부문응가강병원학화내약성감측，근거결과선택합리적항균약물，제고림상료효。
Objective To investigate the clinical distribution of non-fermenting bacteria and drug resis-tance. Methods A total of 8 817 clinical specimens in our hospital from March 2011 to February 2014 were collect-ed for bacterial identification. The clinical distribution and composition of non-fermenting bacteria as well as drug resistance and sensitivity rates were analyzed. Results Among the 8 817 samples, 1 297 pathogenic bacteria were isolated, in which 378 were non-fermenting bacteria (accounting for 29.14%). The top four non-fermenting bacteria detected were Pseudomonas aeruginosa (39.15%), Acinetobacter baumannii (28.57%), Stenotrophomonas maltophilia (11.38%), and Alcaligenes faecalis (4.23%). The non-fermenting bacteria were mainly isolated from specimens of spu-tum, wound secretions, urine, and blood, distributed mainly in First Department of Internal Medicine, Second Depart-ment of Surgery, ICU, and First Department of Surgery. The overall resistance rates of Pseudomonas aeruginosa to me-ropenem, imipenem, levofloxacin, cefepime, cefoperazone/sulbactam, piperacillin/tazobactam were 12.16%, 14.19%, 12.84%, 21.62%, 13.51%, 14.86%, respectively, and the rates of Acinetobacter baumannii to the above six drugs were 27.78%, 23.15%, 26.85%, 28.70%, 10.18%, 27.78%, respectively. Conclusion Non-fermenting bacteria show high incidence of multi-drug resistance. Antimicrobial drugs should be applied rationally according to surveillance of drug resistance and etiology, in order to improve clinical outcomes.
