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目的分析临床分离非发酵菌的分布特点与耐药情况,指导抗菌药物的合理使用。方法对2014年住院患者送检标本进行细菌分离、鉴定以及药敏试验,并对结果进行分析。结果共分离5 200株非发酵革兰阴性杆菌,铜绿假单胞菌检出率最高,共1 877株,检出率36.1%;其他依次为鲍曼不动杆菌(20.5%)、嗜麦芽窄食单胞菌(12.7%)和洋葱伯克霍尔德菌(0.9%)。各种非发酵菌对临床常用抗菌药物呈现不同程度的耐药性,对氨苄西林/舒巴坦、头孢唑啉、头孢呋辛和头孢西丁的耐药率分别高达97.1%、99.0%、99.5%和99.6%;第3、4代头孢类和氨曲南等的耐药率虽比前者低,但也出现不同程度的耐药,最高达80%;对碳青霉烯类和阿米卡星、舒普深、左氧氟沙星等较为敏感。结论临床医生应重视非发酵菌感染和耐药情况,在使用抗菌药物治疗过程中应充分利用微生物实验室提供的监测数据,选择最佳的用药方案。
Objective To analyze the distribution characteristics and drug resistance of non-fermentative clinical isolates and to guide the rational use of antimicrobial agents. Methods Bacterial isolation, identification and drug susceptibility testing of inpatients in 2014 were performed, and the results were analyzed. Results A total of 5 200 strains of non-fermented Gram-negative bacilli were isolated. The highest detection rate of Pseudomonas aeruginosa was 1877 strains, the detection rate was 36.1%, followed by Acinetobacter baumannii (20.5%), (12.7%) and Burkholderia cepacia (0.9%). All kinds of non-fermenting bacteria showed different degrees of resistance to the commonly used antibacterial drugs in clinic. The rates of resistance to ampicillin / sulbactam, cefazolin, cefuroxime and cefoxitin were as high as 97.1%, 99.0% and 99.5 % And 99.6%, respectively. Although the drug resistance rates of 3rd and 4th generation cephalosporins and aztreonam were lower than the former ones, they also showed different degrees of resistance, up to 80%. For carbapenems and amikacin, Star, Shu Pu deep, levofloxacin and other more sensitive. Conclusion Clinicians should attach importance to non-fermentative bacteria infection and drug resistance. In the process of using antimicrobial drugs, the monitoring data provided by the microorganism laboratory should be fully utilized to select the best drug regimen.