摘要
目的了解2006—2008年我院高干病区老年患者耐碳青霉烯类抗生素不发酵糖菌的临床分离菌分布及耐药变化趋势。方法对2006—2008年间高干病区154例老年患者的临床细菌分离阳性标本进行菌株鉴定及药敏试验,按CLSI标准判断结果 ,用WHONET5.4软件进行统计处理,采用SPSS13.0的χ2检验对细菌耐药率进行分析。结果 154例患者共分离出217株耐碳青霉烯类抗生素不发酵糖菌,铜绿假单胞菌占59.0%、鲍曼不动杆菌16.6%、洋葱伯克霍尔德菌12.0%,分离部位以下呼吸道(87.6%)居首位,基础疾病以肺部疾病(72.7%)、高血压(50.0%)和脑血管疾病(37.0%)居多,使用率最高的抗菌药物为碳青霉烯类、β内酰胺类-β内酰胺酶抑制剂、喹喏酮类和头孢菌素类。耐碳青霉烯类抗生素不发酵糖菌对β内酰胺类抗生素耐药率45.5%～100%;对氨基糖苷类抗生素耐药率为33.3%～69.2%。结论耐碳青霉烯类抗生素不发酵糖菌主要分离自呼吸道标本,多重耐药情况较严重,可能与患者基础疾病、侵袭性操作和多种抗菌药使用有关。
Objective To analyze the distribution and carbapenem resistance of the non-fermentative bacterial strains isolated from geriatric patients in a hospital of Guangdong Province during 2006-2008.Methods The nonfermenters were isolated from hospitalized patients. The MICs of these strains were determined. The results were analyzed by using software WHONET 5.4 and CLSI / NCCLS standards,and the χ 2 test of SPSS 13.0.Results A total of 217 strains of carbapenem-resistant non-fermentative bacteria were isolated from 154 hospitalized geriatric patients. The top three species were P. aeruginosa （59.0%）,A. baumannii （16.6%） and Burkholderia cepacia （12.0%）. The nonfermenters were mostly isolated from lower respiratory tract （87.6%）. Pulmonary disease （72.7%）,hypertension （50.0%） and cerebrovascular disease （37.0%） were the most prevalent underlying diseases. Carbapenems,β-lactam/β-lactamase inhibitor combinations,quinolones and cephalosporins were the most frequently used antimicrobial agents. The carbapenem-resistant non-fermentative bacteria showed highest resistance rate to β-lactams （45.5%-100%）,and lowest resistance rate to aminoglycosides （33.3%-69.2%）.Conclusions The carbapenem-resistant non-fermentative bacteria are mostly isolated from lower respiratory tract. These strains are highly resistant to multiple antimicrobial agents. This may be related to underlying diseases,invasive procedures and prior use of multiple antibiotics.
出处
《中国感染与化疗杂志》
CAS
2010年第3期213-215,共3页
Chinese Journal of Infection and Chemotherapy
关键词
耐碳青霉烯类
不发酵糖菌
细菌感染
耐药性
carbapenem-resistant
nonfermenter
bacterial infection
drug resistance
