耐药菌的预防与治疗 倪晨阳 (上海交通大学国际与公共事务学院，上海200240) 摘要：随着广谱抗菌药物的发展，各种耐药菌趋于增多和复杂化，特别是近年来临床上碳青 酶烯类抗菌药物的大量使用，泛耐药菌的感染发生率也有上升趋势。泛耐药菌是指对5~7 个种类抗菌药物均耐药的细菌，包括假单胞菌属、不动杆菌属、寡养单胞菌属等非发酵菌。综 述主要介绍泛耐药菌的预防措施及治疗。 关键词：泛耐药菌 Pandrug-resistant Bacteria: Prevention and Treatment Nichenyang (School of International and Public Affairs,Shanghai Jiao Tong University.Shanghai 200240.China) Abstract:With the development of broad-spectrum antibiotics,a variety of resistant bacteria tends to increase and complicate,especially in recent years.clinical use of large amounts of carbapenem-based antimicrobial drugs,the incidence of pan-resistant bacteria also have an upward trend.Pan-resistant bacteria refers to 5 to 7 kinds of antibacterial drugs are resistant to bacteria, including Pseudomonas,Acinetobacter,Stenotrophomonas and other non-fermentative bacteria.The review mainly introduces the preventive measures and treatment of pan-resistant bacteria. Key words:Pan-resistant bacteria:Prevention:Treatment. 1常见非发酵菌的特点 非发酵菌是指一大群不发酵葡萄糖或仅以氧化形式利用葡萄糖的需氧或兼性厌氧、无芽 胞革兰阴性杆菌，广泛存在于自然界的土壤、水、物体表面、空气中，大多为条件致病菌，常 引起机会性感染。铜绿假单胞菌是非发酵革兰阴性杆菌中毒力最强者，是住院患者特别是危 重患者最常见的定植及感染菌：鲍氏不动杆菌在健康人群中其定植率>40%，而在住院患者中 其定植率为75%，在临床标本分离率仅次于铜绿假单胞菌：嗜麦芽寡养单胞菌列第3位。 2泛耐药菌的耐药机制 非发酵革兰阴性杆菌对多种抗菌药物天然耐药以及使用抗菌药物后又发生获得性耐药，耐药菌的预防与治疗 倪晨阳 （上海交通大学国际与公共事务学院，上海 200240） 摘要：随着广谱抗菌药物的发展, 各种耐药菌趋于增多和复杂化, 特别是近年来临床上碳青 酶烯类抗菌药物的大量使用,泛耐药菌的感染发生率也有上升趋势。 泛耐药菌是指对 5～ 7 个种类抗菌药物均耐药的细菌, 包括假单胞菌属、不动杆菌属、寡养单胞菌属等非发酵菌。 综 述主要介绍泛耐药菌的预防措施及治疗。 关键词：泛耐药菌 Pandrug-resistant Bacteria: Prevention and Treatment Nichenyang (School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200240, China) Abstract: With the development of broad-spectrum antibiotics, a variety of resistant bacteria tends to increase and complicate, especially in recent years, clinical use of large amounts of carbapenem-based antimicrobial drugs, the incidence of pan-resistant bacteria also have an upward trend. Pan-resistant bacteria refers to 5 to 7 kinds of antibacterial drugs are resistant to bacteria, including Pseudomonas, Acinetobacter, Stenotrophomonas and other non-fermentative bacteria. The review mainly introduces the preventive measures and treatment of pan-resistant bacteria. Key words:Pan-resistant bacteria; Prevention; Treatment. 1 常见非发酵菌的特点 非发酵菌是指一大群不发酵葡萄糖或仅以氧化形式利用葡萄糖的需氧或兼性厌氧、无芽 胞革兰阴性杆菌, 广泛存在于自然界的土壤、水、物体表面、空气中, 大多为条件致病菌, 常 引起机会性感染。 铜绿假单胞菌是非发酵革兰阴性杆菌中毒力最强者, 是住院患者特别是危 重患者最常见的定植及感染菌;鲍氏不动杆菌在健康人群中其定植率>40%, 而在住院患者中 其定植率为 75%,在临床标本分离率仅次于铜绿假单胞菌;嗜麦芽寡养单胞菌列第 3 位。 2 泛耐药菌的耐药机制 非发酵革兰阴性杆菌对多种抗菌药物天然耐药以及使用抗菌药物后又发生获得性耐药