2014-2016年临床主要非发酵菌分布及抗菌药物敏感性变迁分析
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摘要
目的了解该院2014-2016年的非发酵菌临床分布及对抗菌药物敏感性变迁,为临床提供参考依据。方法回顾性分析2014-2016年分离出的2 398株非发酵菌临床分布及抗菌药物敏感性情况。结果3年间共分离出非发酵菌2 398株,主要是鲍曼不动杆菌1 019株(42.5%),其次是铜绿假单胞菌1 016株(42.4%)。ICU主要非发酵菌分离株为727株(30.3%),居所有科室第一,仍以鲍曼不动杆菌占首位。鲍曼不动杆菌对抗菌药物的敏感率绝大多数呈逐年降低趋势,为25.0%~40.0%,尤其是ICU大多数敏感率都低于10.0%。而铜绿假单胞菌对多种抗菌药物如头孢他啶、头孢吡肟、亚胺培南、环丙沙星、左氧氟沙星等敏感率均呈上升趋势,其敏感率均>70.0%。结论鲍曼不动杆菌和铜绿假单胞菌为非发酵菌临床分布的主要病原菌,前者对抗菌药物的敏感率绝大多数呈逐年降低趋势,尤其是ICU形势严峻;后者的敏感率呈逐年上升趋势,有利于临床选择抗菌药物。
Objective To investigate the distribution and antibiotics resistance of the major non-fermenting bacteria in our hospital from 2011 to 2016,then provide a reference for clinic practice.Methods Retrospectively analyze clinical distribution and antimicrobial susceptibility of 2 398 non-fermenting bacteria from 2014 to2016.Results Over the past 3 years,2 398 main non fermented bacteria were isolated,mainly 1 019 strains of Acinetobacter Bauman(42.5%),followed by Pseudomonas aeruginosa 1 016(42.4%).The main non fermentative bacteria isolated from ICU were 727 strains(30.3%),ranking the first in all departments,and the Acinetobacter Bauman was the top.The sensitivity rate of Acinetobacter Bauman to antibiotics was decreasing year by year,as low as 25.0%-40.0%.Especially in ICU,the sensitivity rates were less than 10.0%.The susceptibility rates of Pseudomonas aeruginosa to a variety of antibiotics,such as ceftazidime,cefepime,imipenem,ciprofloxacin,levofloxacin,were all increased,and the sensitivity was>70.0%.Conclusion Acinetobacter and Pseudomonas aeruginosa were the main pathogenic bacteria in the clinical distribution of non fermenting bacteria.The most sensitive rate of the former to antibiotics was decreasing year by year,especially the ICU situation was severe,the sensitivity of the latter was increasing year by year,which was beneficial to the clinical selection of antimicrobial agents.
Objective To investigate the distribution and antibiotics resistance of the major non-fermenting bacteria in our hospital from 2011 to 2016,then provide a reference for clinic practice.Methods Retrospectively analyze clinical distribution and antimicrobial susceptibility of 2 398 non-fermenting bacteria from 2014 to2016.Results Over the past 3 years,2 398 main non fermented bacteria were isolated,mainly 1 019 strains of Acinetobacter Bauman(42.5%),followed by Pseudomonas aeruginosa 1 016(42.4%).The main non fermentative bacteria isolated from ICU were 727 strains(30.3%),ranking the first in all departments,and the Acinetobacter Bauman was the top.The sensitivity rate of Acinetobacter Bauman to antibiotics was decreasing year by year,as low as 25.0%-40.0%.Especially in ICU,the sensitivity rates were less than 10.0%.The susceptibility rates of Pseudomonas aeruginosa to a variety of antibiotics,such as ceftazidime,cefepime,imipenem,ciprofloxacin,levofloxacin,were all increased,and the sensitivity was>70.0%.Conclusion Acinetobacter and Pseudomonas aeruginosa were the main pathogenic bacteria in the clinical distribution of non fermenting bacteria.The most sensitive rate of the former to antibiotics was decreasing year by year,especially the ICU situation was severe,the sensitivity of the latter was increasing year by year,which was beneficial to the clinical selection of antimicrobial agents.
引文
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[10]余建,王飞,严伟.我院2009年铜绿假单胞菌感染分布及耐药性分析[J].中国卫生检验杂志,2010,20(10):2514-2515.
[11]郭小惠.铜绿假单胞菌耐药性的最新研究进展[J].国际检验医学杂志,2011,32(9):968-971.
[12]李永伟,刘心伟,王春霞,等.多重耐药性铜绿假单胞菌的耐药特点及预防对策[J].中国现代医药杂志,2016,18(4):76-78.
[13]储从家,吴惠玲.445株嗜麦芽窄食单胞菌的分布和耐药性分析[J].中国微生态学杂志,2014,8(26):928-930.
[14]王凌燕,朱光发,王爱萍.不发酵糖革兰阴性杆菌的分布和耐药性分析[J].中国感染与化疗杂志,2014,14(4):305-309.
[15]张进军,杨怀德,向雪琼,等.非发酵菌在临床标本中的检出及耐药性分析[J].中国感染控制杂志,2010,9(1):49-52.
[2]江云兰,鲁梅丽.3种常见非发酵菌革兰阴性菌的耐药性探讨[J].中华医院感染学杂志,2012,22(2):389-390.
[3]李可可,陈晓青,邵海鑫,等.2012-2015年某院临床分离2 408株非发酵菌耐药性分析[J].现代预防医学,2017,44(15):2869-2872.
[4]史文元,吴意.常见非发酵革兰阴性杆菌的分布与耐药特性分析[J].世界临床医学,2017,11(5):227-228.
[5]刘心睿,杨洪发,薛建红,等.2005-2007年吉大一附院神经外科鲍曼不动杆菌临床耐药性分析[J].中国实验诊断学,2009,13(2):220-222.
[6]王瑶,徐英春,胡云建,等.SEANIR监测中国15所教学医院不发酵糖革兰阴性杆菌对13种抗菌药物的药敏试验[J].中国感染与化疗杂志,2012,12(4):268-275.
[7]沈黎,周宏,姜亦虹,等.140所ICU医院感染病原菌分布及耐药性分析[J].中华医院感染学杂志,2012,22(21):4900-4902.
[8]范学财,王勇.2012-2013某院鲍曼不动杆菌的分布及耐药情况分析[J].国际检验医学杂志,2014,35(16):2192-2193.
[9]胡付品,朱德姝,江复,等.2013年中国CHINET细菌药敏性监测[J].中国感染与化疗杂志,2014,14(5):369-378.
[10]余建,王飞,严伟.我院2009年铜绿假单胞菌感染分布及耐药性分析[J].中国卫生检验杂志,2010,20(10):2514-2515.
[11]郭小惠.铜绿假单胞菌耐药性的最新研究进展[J].国际检验医学杂志,2011,32(9):968-971.
[12]李永伟,刘心伟,王春霞,等.多重耐药性铜绿假单胞菌的耐药特点及预防对策[J].中国现代医药杂志,2016,18(4):76-78.
[13]储从家,吴惠玲.445株嗜麦芽窄食单胞菌的分布和耐药性分析[J].中国微生态学杂志,2014,8(26):928-930.
[14]王凌燕,朱光发,王爱萍.不发酵糖革兰阴性杆菌的分布和耐药性分析[J].中国感染与化疗杂志,2014,14(4):305-309.
[15]张进军,杨怀德,向雪琼,等.非发酵菌在临床标本中的检出及耐药性分析[J].中国感染控制杂志,2010,9(1):49-52.