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目的:了解住院患者常见非发酵糖革兰阴性杆菌的临床分布和耐药特征,为临床抗感染治疗提供参考依据。方法:收集汕头潮南民生医院2009年4月1日～2010年3月31日住院患者送检标本分离的细菌,采用微量稀释法和部分纸片扩散法(Kirby-Bauer法)进行药敏试验,结果判断按照美国临床实验室标准化研究所(CLSI)2007年版标准。结果:临床分离的156株非发酵糖革兰阴性杆菌中,铜绿假单胞菌49株(31.4%),不动杆菌属74株(47.4%)以及嗜麦芽窄食单胞菌33株(21.2%)。对铜绿假单胞菌敏感率较高的是多粘菌素E(100.0%)、哌拉西林/他唑巴坦(93.9%)、美罗培南(91.8%)、头孢哌酮/舒巴坦(91.8%);对不动杆菌属敏感率较高的是多粘菌素E(100.0%)、头孢哌酮/舒巴坦(74.3%)、亚胺培南(29.7%)和美罗培南(41.9%),对其余14种抗菌药物耐药率均在70%以上;对嗜麦芽窄食单胞菌敏感率较高的是复方磺胺甲唑(100.0%)、左氧氟沙星(72.7%),对其余16种抗菌药物多数呈高度耐药。结论:非发酵糖革兰阴性杆菌是引起医院感染的主要病原菌,对多种抗菌药物呈高度耐药,临床应密切监测并根据药敏试验结果合理选用抗菌药物,避免滥用,以减少耐药菌株的产生;同时应加强对医院环境消毒和增强医务人员的无菌操作意识。
Objective: To understand the clinical distribution and drug resistance characteristics of common non-fermentative Gram-negative bacilli in hospitalized patients and provide a reference for clinical anti-infection treatment. Methods: The bacteria isolated from hospitalized patients were collected from Jan. 1, 2009 to Mar. 31, 2010 in Shantou Chaonan Minsheng Hospital. Microbial dilution and partial disk diffusion (Kirby-Bauer method) were used for susceptibility testing , The results of judgment in accordance with the American Society for Clinical Laboratory Standards (CLSI) 2007 version of the standard. Results: Among 156 non-fermentative Saccharomyces Gram-negative bacilli isolated from clinical isolates, 49 (31.4%) were Pseudomonas aeruginosa, 74 (47.4%) Acinetobacter and 33 %). Polymyxins E (100.0%), piperacillin / tazobactam (93.9%), meropenem (91.8%), cefoperazone / sulbactam ( 91.8%). The highest susceptibilities to Acinetobacter were polymyxin E (100.0%), cefoperazone / sulbactam (74.3%), imipenem (29.7%) and meropenem (41.9% ), The remaining 14 kinds of antimicrobial resistance rates were above 70%; Stenotrophomonas maltophilia sensitive compound sulfamethoxazole (100.0%), levofloxacin (72.7%), the remaining 16 Most antibacterial drugs are highly resistant. Conclusion: Non-fermentable Saccharomyces Gram-negative bacilli are the main pathogenic bacteria that cause nosocomial infection. They are highly resistant to a variety of antimicrobial agents. Clinically, they should be closely monitored and rational use of antimicrobial agents should be based on the susceptibility test results to avoid abuse and to reduce drug-resistant strains ; At the same time, we should strengthen the disinfection of the hospital environment and enhance the sense of aseptic operation of medical staff.