亚胺培南临床用药与非发酵菌群分离率和耐药性的关系

目的了解亚胺培南临床用药和非发酵菌群分离率与耐药性变迁的关系，有利于非发酵菌感染的预防与治疗。方法统计分析浙江省人民医院2000～2003年临床分离非发酵菌的菌株分布、与亚胺培南的临床用药的相关性及耐药率。结果4年来非发酵菌的分离以铜绿假单胞菌(30．7％)、乙酸钙-鲍曼不动复合杆菌(19．％)及嗜麦芽糖寡养单胞菌(19．1％)为主．其分离率与亚胺培南用药存在相关性。对各菌属的主要菌种进行耐药性分析，嗜麦芽糖寡养单胞菌、脑膜脓毒性金黄杆菌和洋葱伯克霍尔德菌的耐药率极高，铜绿假单胞菌和乙酸钙-鲍曼不动复合杆菌的耐药率呈现明显升高的趋势。结论非发酵菌的检出率与亚胺培南使用关系密切，耐亚胺培南的菌株迅速升高。临床应合理使用抗生素，并加强对耐药菌株的监控。

The relation clinical use of Imipenem to isolated rates of nonfermentative bacilli and drug resistance

Objective To study the relation among the clinical use of Imipenem and the isolation of nonfermentative bacilli and the changing of drug resistance in order to prevent and treat the infection of nonfermentative bacilli. Methods To analyze statically the distribution of nonfermetative bacilli isolated in our hospital from 2000 to 2003, the relativity of the clinical use and the drug resistant rate of Imipenem.Results Among the nonfermentative bacilli, the isolation of Psedomonas aeruginose(30.7%), Acinetobater baumannii calcoaceticus(19.6%) and Stenotrophomonas maltophilia(19.1%) were predominant, which were related to the use of Imipenem.The drug resistance of Stenotrophomonas maltophili and Burkholderia cepacia were very high and that of Psedomonas aeruginose and Acinetobater baumannii calcoaceticus were apparently.Conclusions The detecting rate of nonfermentative bacilli were related to the use of Imipenem significantly, and Imipenem-resistant bacteria were increased rapidly, so antibiotics should be used rationally and the drug resistant bacteria should be surveyed.