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目的了解医院内下呼吸道感染常见非发酵菌的分布及耐药性变化情况,为临床合理用药提供依据。方法对医院2003-2007年下呼吸道感染住院患者痰标本所分离的非发酵菌的菌种分布和耐药性资料进行回顾性统计分析。结果非发酵菌排前4位依次是铜绿假单胞菌、鲍氏不动杆菌、鲁氏不动杆菌和嗜麦芽寡养单胞菌;非发酵菌对15种常用抗菌药物的耐药性总体呈上升趋势,5年变化较为明显的是铜绿假单胞菌对头孢他啶的耐药率从2003年的30.2%升至2005年的55.4%,2006年保持在54.8%,2007年回落到41.5%;对庆大霉素的耐药率从2003年的20.8%升至2007年的36.1%;对亚胺培南、奈替米星、替卡西林和妥布霉素的耐药率也上升较明显;鲍氏不动杆菌对亚胺培南耐药率上升最为显著,5年从21.1%升至59.7%,鲁氏不动杆菌耐药率仍较低,嗜麦芽寡养单胞菌对15种常用抗菌药物呈现多药耐药,除对复方新诺明以及头孢他啶、替卡西林耐药率较低外,其余均在61.9%～100.0%。结论非发酵菌是下呼吸道感染主要革兰阴性杆菌,其中以铜绿假单胞菌、鲍氏不动杆菌和嗜麦芽寡养单胞菌最为常见且呈多药耐药,耐药率有上升趋势。
Objective To understand the distribution and resistance changes of common non-fermentative bacteria in lower respiratory tract infections in hospitals and provide basis for clinical rational drug use. Methods Retrospective statistical analysis was carried out on the distribution and drug resistance of non-fermentative bacteria isolated from sputum samples of hospitalized patients with lower respiratory tract infection from 2003 to 2007 in our hospital. Results The top four non-fermentative bacteria were Pseudomonas aeruginosa, Acinetobacter baumannii, Acinetobacter baumannii and Stenotrophomonas maltophilia. The resistance of non-fermentative bacteria to 15 commonly used antibiotics was The trend of 5-year change is that the resistance rate of Pseudomonas aeruginosa to ceftazidime increased from 30.2% in 2003 to 55.4% in 2005, 54.8% in 2006 and 41.5% in 2007; The resistance rate to gentamicin increased from 20.8% in 2003 to 36.1% in 2007; the resistance rates to imipenem, netilmicin, ticarcillin and tobramycin also increased significantly ; Acinetobacter baumannii resistance rates to imipenem rose most significantly, 5 years from 21.1% to 59.7%, the resistance rate of Acinetobacter was still low, Stenotrophomonas maltophilia 15 Commonly used antimicrobial drugs showed multidrug resistance, in addition to the cotrimoxazole and ceftazidime, ticarcillin resistance rate is low, the rest were 61.9% to 100.0%. Conclusion Non-fermentative bacteria are the major Gram-negative bacilli in lower respiratory tract infection. Of them, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia are the most common and multi-drug resistant strains with an upward trend .