鲍氏不动杆菌的临床分布特征及耐药性分析

Characteristics of distribution and antimicrobial resistance of Acinetobacter baumannii

目的了解医院鲍氏不动杆菌感染的临床分布及其耐药特点,为临床合理用药提供理论依据,预防并减少医院感染的发生。方法收集2008-2010年医院临床分离的268株鲍氏不动杆菌,分析其临床分布特征及耐药状况。结果鲍氏不动杆菌主要来自于呼吸道标本,共215株,占80.22%;临床分布以呼吸内科为主,占35.45%,其次为ICU,占27.24%;鲍氏不动杆菌对β-内酰胺类、喹诺酮类药物有较高的耐药率,对碳青霉烯类、氨基糖苷类敏感性较高。结论碳青霉烯类抗菌药物对鲍氏不动杆菌感染仍有较强活性,但鲍氏不动杆菌对加有β-内酰胺酶抑制剂的复合药物敏感性差异较大,应避免经验用药;鲍氏不动杆菌检出率有上升趋势,对多种药物耐药率较高,多药耐药现象严重,故加强其耐药性检测,合理选择抗菌药物,是预防和控制鲍氏不动杆菌医院感染的有效措施。

OBJECTIVE To investigate the distribution and antimicrobial resistance of Acinetobacter baumannii in hospital,so as to provide theoretical basis for reasonable use of antibiotics and prevent and reduce nosocomial infections.METHODS Totally 268 strains of A.baumannii isolated from 2008 to 2010 were collected,and the distribution and antimicrobial resistance of A.baumannii were analyzed.RESULTS There were 215（80.22%） isolates which were obtained mainly from the respiratory tract specimens;A.baumannii strains were largely distributed in respiratory medicine（35.45%）,followed by ICU（27.24%）;A.baumannii strains were highly resistant to the β-lactam antibiotics and fluroquinolones antibiotics,and were highly susceptible to carbapenems or aminoglycosides antibiotics.CONCLUSION Carbapenems antibiotics still have strong antimicrobial activity against A.baumannii,there is significant difference in the drug susceptibility of A.baumannii to antimicrobial agents containing β-lactamase inhibitors,it should avoid the empirical use of antibiotics;in recent years,the detection rate of the A.baumannii strains kept an upward tendency,A.baumannii strains are seriously multidrug-resistant so that it is necessary to strengthen the detection of drug resistance and reasonably use antibiotics,which is the effective way to prevent and control A.baumannii infections.