重症监护病房非发酵菌的分布及耐药性分析

目的分析重症监护病房(ICU)非发酵菌感染的临床分布及耐药状况,总结非发酵菌的感染特点,探讨治疗对策。方法采用ATB Expression细菌鉴定及药敏分析系统,对ICU非发酵菌临床分离株进行菌种鉴定及耐药性测定。结果重症监护病房医院感染非发酵菌检出率为45.0%。其中铜绿假单胞菌为最常见(32.1%),其次为鲍氏不动杆菌(27.4%)和嗜麦芽窄食单胞菌(13.3%)。非发酵菌可感染不同部位,其中以呼吸道感染为最常见(75.5%),其次为创面分泌物(8.7%)和引流液(5.5%)。药敏结果显示非发酵菌对替卡西林、庆大霉素、喹诺酮类等多种抗菌药物高度耐药,且多重耐药现象较严重。结论重症监护病房医院感染中非发酵菌分离率高,分布范围广泛且耐药性强,多重耐药现象严重,应引起临床高度重视。

Clinical distribution and antibiotic resistance of non-fermenters isolated from intensive care unit

Objective To analyse the antibiotic resistance and clinical distribution of non-fermenters isolated from ICU so as to facilate a further study of clinical treatment.Method Identifications and antibiotic resistanece assays of non-fermenters were done by ATB Expression bacteria analysis system.Results The isolation rate of non-fermenters in ICU was 45.0%.The most common pathogen was Pseudomonas aeruginosa(32.1%),the next was Acietobacter baumanii(27.4%) and Pseudomona maltophilia(13.3%).They could infect any external sites or organ,and be isolated from respiratory tract(75.5%),secretions of surgical wounds(8.7%) and drawing fluid(5.5%). These non-fermenters were highly resistant to such antibiotics as teicoplanin gentamycin and quinolones.And cross resistances were very common.Conclusions The isolation rate of non-fermentaters was very high in nosocomial infection in patient of ICU.Non-fermenters can be isolated from a wide varied sources,and its cross resistance to most available antibictics were rather high.It is very important to pay high clinical attention to those strains for the clinical treatments.