129株鲍曼不动杆菌所致医院感染的耐药性分析

Analysis of Antibiotic Resistant Patterns and Clinical Distribution of Acinetobacter Baumannii in Nosocomial Infections

目的了解鲍曼不动杆菌在医院感染中的流行及药敏特征,为临床抗感染治疗提供依据。方法对2004年从我院临床送检标本所分离129株鲍曼不动杆菌的分布及药敏结果进行回顾性分析。结果鲍曼不动杆菌在重症监护病房(ICU)检出率最高为31.8%,其次为移植科(23.3%);感染部位以呼吸道和手术切口为主,分别占50.4%和40.3%;该菌对左氟沙星耐药率最低(8.53%),其次为磷霉素、美罗培南和头胞哌酮/舒巴坦,分别为10.1%、17.1%;耐药率最高的为呋喃妥因(92.2%),其次依次为头胞唑林(83.7%)、环丙沙星(75.2%)、氨卞西林(72.1%)和头胞呋肟(71.3%),其他抗生素也有不同程度的耐药。结论鲍曼不动杆菌是目前医院感染重要的条件致病菌,其抗生素耐药率呈逐步升高趋势,且耐药机制复杂,多重耐药率高,应引起临床的高度重视。

Objective To find the prevalence and distribution of nosocomial infections of Acinetobacter baumannii and its characteristics of antibiotic susceptibility and provide strategies for prevention and treatment. Method The 2004 registered 129 Acinetobacter baumannii isolates and their drug resistance were retrospectively analyzed. Results The incidence of Acinetobacter baumannii was highest in the intensive care units（31.8 % ）, and followed by the department of transplantation （23.3 % ）. Respiratory tracts and the surgical wounds exhibited as the major infected sites, and the incidences were 50.4 % and 40.3 % respectively. The rate of resistance to levofloxacin was the lowest （8.53 % ）, followed by fosfomycin（ 10.1% ）, meropenem（ 10. 1% ）, and cefoperazong/sul （17.1% ） ; while resistance to nitrofurantoin was the highest（92.2 % ）, followed by cefazolin （83.7%）, ciprofloxacin（75.2%）, ampicillin（72. 1%） and cefuroxime（71.3%）, and other antibiotics. Con. clusion Acinetobacter baumannii is a major emerging nosocomial opportunistic pathogen in hospital, which shows increasing drug resistance and even multiple drug resistance with important clinical impact.