【摘要】 目的分析临床常见3种非发酵革兰阴性杆菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法细菌培养严格按《全国临床检验操作规程》进行;细菌鉴定及药敏试验采用法国生物梅里埃ATB Expression鉴定仪及配套试剂条,药敏结果参照美国临床实验室标准化研究所(CLSI)2009折点进行判定。结果共分离出非发酵革兰阴性杆菌140株,其中铜绿假单胞菌(PAE)80株(57.1%),鲍氏不动杆菌(ABA)48株(34.3%)和嗜麦芽窄食单胞菌(SMA)12株(8.6%)。PAE、ABA对氨苄西林-舒巴坦、头孢他啶、阿米卡星、环丙沙星、增效磺胺甲基异恶唑耐药率分别为98.7%、10.0%、10.0%、35.0%、97.5%和87.5%、25.0%、18.8%、62.5%、81.3%;SMA对替卡西林-克拉维酸、头孢他啶、环丙沙星、亚胺培南、多粘菌素E耐药率分别为91.7%、91.7%、83.3%、100.0%、100.0%,对增效磺胺甲基异恶唑100.0%敏感。结论非发酵革兰阴性杆菌耐药严重,应根据药敏结果合理使用抗菌药物。更多还原

【Abstract】 Objective To investigate the clinical distribution and antimicrobial resistance of three species of common non-fermentative Gram-negative bacteria,and provide etiological evidence for appropriate use of antibiotics. MethodsBacterial culture was performed following National Guide for Clinical Laboratory Procedures. Strain identification and antimicrobial susceptibility testing were carried out with ATB Expression system(bioMerieux) with ancillary reagent strip. The susceptibility testing results were assessed according to CLSI 2009 breakpoints. Results Among 140 strains of nonfermentative Gram-negative bacteria isolated from clinical specimens, Pseudomonas Aeruginosa(PAE), Acinetobacter baumannii(ABA) and Stenotrophomonas maltophilia(SMA) were found to be 80(57. 1%),48(34. 3%),12(8. 6%), respectively. Resistance ratios in PAE and ABA to ampicillin/sulbactam(FAM), ceftazidime(CAZ), amikacin(AKN), ciprofloxacin(CIP), and cotrimoxazole(TSU) were 98.7%,10.0%,10.0%,35.0%,97.5% and 87.5%,25.0%,18.8%, 62.5% and 81.3%,respectively. Resistance ratios in SMA toticarcillin/clavulanic acid, CAZ, CIP,imipenem,colistin E were 91. 7%,91. 7%,83. 3%,100. 0% and 100. 0% while sensitivity ratio to TSU was 100. 0%. Conclusion The antimicrobial resistance of non-fermentative Gram-negative bacteria was clinically serious. Antibiotics should be prescripted following the orientation of susceptibility testing.更多还原