62例鲍曼不动杆菌的感染分布和耐药性分析

Infection distribution and drag resistance analysis in 62 strains infections of acinetobacter baumanii

目的了解鲍曼不动杆菌感染的临床分布及其耐药特点。方法收集2006年1～6月临床送检的感染标本中分离出的62株鲍曼不动杆菌,结合痛程记录了解其临床分布及药敏试验,比较其耐药率。结果62株鲍曼不动杆菌通过临床排查有13株为院外感染,49株为院内感染,其中院内感染分布以ICU最多(21例,42．8％),且以老年患者多见(17例,26．98％)；对头孢3代和喹诺酮类以及左氧氟沙星的耐药率均＞50．0％。对亚胺培南、美罗培南、多黏菌素B、多黏菌素E的耐药性较低,分别为22．4％、22．4％、0％、10．2％。院外感染的13株鲍曼不动杆菌对大多数抗菌药物都敏感；仅对头孢哌嗣、拉氧头孢、氨曲南、奈替米星、复方新诺明的耐药率超过了50％。结论碳青酶烯类及多黏菌素类对鲍曼不动杆菌感染仍有较强的活性,但不能忽视对这两类药物耐药的多重菌株的出现,要减少多重耐药菌株的产生,必须注意抗菌药物的合理使用。

Objective To study the clinical distribution and drug resistance characteristics of acinetobacter baumanii infection, Methods Sixty-two strains of acinetobacter baumanii were separated from January to June in 2006. Clinical distribution, drug sensitivity and drug resistance were studied. Results In the 62 strains of acinetobacter baumanii, 13 strains were pathogens of out-hos- pital infection, and 49 strains were pathogens of hospital acquired infection. Among the hospital acquired infection, pathogens sep arated from ICU was the highest （21/49, 42. 8%）, and pathogens separated from elder was common （26. 98%）. The resistant rates of third generation of cephalospornsa, quimolones and levofloxacin were higher than 50%. The resistant rates of imipenem, meropenem, polymycin B and polymycin E were 22.4 %, 22.4 %, 0 % and 10.2 % separately. Thirteen strains of out-hospital infec ted acinetobacter baumanii were sensitive to most of antibiotics, and only the resistant rates of cefoperazone, latamoxefsodium, aztreonam, netilmicin and SMZ were higher than 50%. Conclusion Acinetobacter baumanii is sensitive to carbapenem and polymycin. It is important to avoid the presence of multi-reslstant strains and necessary to strengthen the rational application of antibiotics.