重症监护室非发酵菌的检出率及其耐药性分析

目的:回顾性分析某医院重症监护室(ICU)2010年1月1日-2010年12月31日之间感染病原菌中非发酵菌的分布及其耐药情况。方法:用VITEK-32仪鉴定细菌,K-B纸片扩散法做体外药敏试验,统计、分析非发酵菌的检出率和药敏结果。结果:560份ICU标本,医院感染分离菌株335株。其中,非发酵菌181株。非发酵菌的阳性检出率为32.32%,其中,铜绿假单胞菌最为常见(65株,19.40%),其次为鲍曼不动杆菌(53株,15.82%)、洋葱假单胞(31,9.25%)和嗜麦芽窄食单胞菌(28,8.36%)。分离菌中标本来源以口痰最常见,其次为静脉导管、静脉血和胸腹水。铜绿假单胞菌、鲍曼不动杆菌、洋葱假单胞和嗜麦芽窄食单胞菌对多种抗菌药物均具有较高的耐药性。结论:医院感染病原菌中非发酵菌的检出率较高且耐药性强;治疗非发酵菌感染应根据体外药敏试验结果选用敏感的抗菌药物,以减低耐药率。

Detection Rate and Drug Resistance Analysis of Non-fermenting Bacteria in ICU

Objective: To evaluate the detection rate and antimicrobial resistance of non-fermenters in ICU.Methods: The bacteria were identified by VITEK-32,and the antimicrobial susceptibility tests were done according to disc agar diffusion methods.Results: In 560 ICU specimens,there were 335 strains of hospital infection separated strains.Among them,181 strains of non-fermentative bacteria were detected.The non-zymophyte’s positive detection rate was 32.32%,pseudomonas aeruginosa was the most common bacterium(65 strains,19.40%),the next was acinetobacter baumannii(53 strains,15.82%),pseudomonas cepacia(31 strains,9.25%) and stenotrophomonas maltophilia(28 strains,8.36%).The most common specimen source was sputum,venous duct,venous blood,hydrothorax and ascites.P.aeruginosa,A.baumannii,P.cepacia and S.maltophilia showed high antimicrobial resistance.Conclusion: The detection rate of non-fermenters was high in the nosocomial infection of ICU patients with high antimicrobial resistance,the drugs should be chosen according to the results of the antimicrobial susceptibility test.