2011-2013年非发酵革兰阴性杆菌耐药监测结果分析
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郑望春

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R969.3

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Surveillance on antimicrobial resistance of nonfermentative gramnegative bacilli in 2011— 2013
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    目的回顾性分析某院2011—2013年非发酵革兰阴性杆菌(NFGNB)耐药监测结果,指导临床合理使用抗菌药物。方法采用美国BD Phoenix100全自动微生物鉴定仪对检出的NFGNB进行鉴定和微量稀释法进行药敏分析。结果2011—2013年共检出NFGNB 3 138株,其中铜绿假单胞菌1 746株(55.64%),鲍曼不动杆菌948株(30.21%),嗜麦芽窄食单胞菌398株(12.68%),洋葱伯克霍尔德菌46株(1.47%)。标本来源主要为呼吸道标本(占56.53%),主要科室为重症医学科(占26.48%)。铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类、β内酰胺酶抑制剂复方抗菌药物、氨基糖苷类等抗菌药物耐药率每年存在变化,未出现逐年升高的趋向,2013年耐药率下降;铜绿假单胞菌对头孢吡肟(FEP)、氨曲南(ATM)、莫西沙星(MXF)的耐药率高(MXF耐药率>90%);鲍曼不动杆菌对大部分抗菌药物的耐药率较高;嗜麦芽窄食单胞菌对复方磺胺甲口恶唑(SXT)的耐药率较低。结论NFGNB 对抗菌药物耐药率每年存在变化,鲍曼不动杆菌对大部分抗菌药物的耐药率较高,临床医生需要根据药敏试验规范合理用药,积极控制感染。

    Abstract:

    ObjectiveTo analyze the surveillance result of antimicrobial resistance of nonfermentative gramnegative bacilli(NFGNB) from a hospital in  2011—2013, and guide rational antimicrobial use. MethodsNFGNB were identified by US BD Phoenix100 automated microbial identification system, and antimicrobial susceptibility analysis were tested by microdilution method.ResultsA total of 3 138 NFGNB were isolated in 20112013, the detection rate of Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter baumannii(A. baumannii), Stenotrophomonas maltophilia (S. maltophilia), and Burkholderia cepacia was 55.64% (n=1 746),30.21% (n=948),12.68% (n=398),and 1.47% (n=46)respectively. Respiratory specimens was the main specimen source(56.53%), strains were mainly isolated from patients in department of critical care medicine(26.48%); resistant rates of P. aeruginosa and A. baumannii to carbapenems, βlactamase inhibitors, and aminoglycosides changed every year, but did not increase year by year, and declined in 2013; resistant rate of P. aeruginosa to cefepime, aztreonam, and moxifloxacin were all high(resistant to moxifloxacin was >90%);  resistant rates of  A.baumannii to most antimicrobial agents were high; resistant rate of S. maltophilia to compound sulfamethoxazole was relatively low.ConclusionAntimicrobial resistant rates of NFGNB changed each year, A. baumannii has a higher resistant rates to most antimicrobial agents, clinicians should use antimicrobial agents according to antimicrobial susceptibility testing result

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李欣影, 黄剑芳, 郑望春.2011-2013年非发酵革兰阴性杆菌耐药监测结果分析[J]. 中国感染控制杂志,2015,14(7):472-475. DOI:10.3969/j. issn.1671-9638.2015.07.010.
LI Xinying, HUANG Jianfang, ZHENG Wangchun. Surveillance on antimicrobial resistance of nonfermentative gramnegative bacilli in 2011— 2013[J]. Chin J Infect Control, 2015,14(7):472-475. DOI:10.3969/j. issn.1671-9638.2015.07.010.

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  • 收稿日期:2015-02-09
  • 最后修改日期:2015-04-22
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  • 在线发布日期: 2015-07-30
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