Distribution and drug resistance of nonfermenters in intensive care units

Objective　To determine the distribution and drug resistance of nonfermenters in intensive care units (ICU), providing evidence for the clinical administration of antibacterial drugs. Methods　Retrospective and statistical analysis was performed based on the results of bacterial culture and sensitivity test for infected patients in ICU from July 2007 to September 2008. Results　A total of 952 isolates of nonfermenters were identified out of 4109 samples. The top four predominant strains were IBurkholderia cepacia/I (243, 25.5%), IPseudomonas aeruginosa/I (200, 21.0%), IAcinetobacter baumannii/I (163, 17.1%), and IStenotrophmonas maltophilia/I (148, 15.6%). The sensitivity test results showed that IBurkholderia cepacia/I possessed the lowest resistance to piperacillin/tazobactam and cotrimoxazole as 2.5% and 9.5%; Pseudomonas aeruginosa had over 20% resistance to a variety of antibiotics, the minimum rate being 22.0% to amikacin and the resistance to other anti-bacterial drugs ranging from 32.0% to 95.0%; IAcinetobacter baumannii/I was over 50% resistant to various antibiotics and most strains presented multi-drug resistance; maltophilia had the slightest resistance to cotrimoxazole, 4.1%, with the resistance to other antibiotics such as the third- and fourth-generation cephalosporins, aminoglycosides and ampicillin / sulbactam and aztreonam, except for ceftazidime, ranging from 79.7% to 95.9%. Besides, it possessed the natural resistance to imipenem. Conclusion　IBurkholderia cepacia, Pseudomonas aeruginosa, Acinetobacter baumannii/I, and IStenotrophmonas maltophilia/I constituted the major non-fermenting bacteria to cause infections in ICUs. Given their high resistance to a series of antibiotics, great importance should be attached to the resistance surveillance and proper administration in accordance with the sensitivity test results in order to minimize drug-resistant strains.