373株不动杆菌的药物敏感性试验

Susceptibility of 373 Acinetobacter isolates

目的了解我院临床分离不动杆菌属对15种抗菌药物的耐药性，为耐药菌感染的抗菌药物选择提供依据。方法收集我院2005年7月至2006年6月所有不动杆菌临床分离株，采用琼脂稀释法测定15种抗菌药物对该菌的最低抑菌浓度。结果本研究共包括373株不动杆菌，其中鲍曼不动杆菌352株，洛菲不动杆菌21株。药敏结果显示，鲍曼不动杆菌对多黏菌素B最为敏感，细菌耐药率仅为2．6％；其次对头孢哌酮-舒巴坦、美罗培南和亚胺培南，耐药率约为15％；对左氧氟沙星、哌拉西林-三唑巴坦、头孢毗肟、氨苄西林-舒巴坦和哌拉西林的耐药率为37．5％～59．9％；对环丙沙星、阿米卡星、头孢噻肟、头孢他啶、复方磺胺甲嘿唑和庆大霉素的耐药率均大于60％。与鲍曼不动杆菌相比，除多黏菌素B外，洛菲不动杆菌对上述药物的耐药率明显较低，对多数抗菌药物的耐药率在30％以下。结论不动杆菌属是医院感染的重要病原菌，耐药率高，部分菌株呈多重耐药，治疗用药应参考药敏试验结果。

Objective To study the resistance of Acinetobacter isolates in Huashan Hospital, Fudan University. Methods Nonduplicate clinical Acinetobacter isolates were collected from July 2005 to June 2006 in Huashan Hospital, Fudan University. Minimum inhibitory concentrations（MICs） of 15 antibiotics were determined by agar dilution technique.. Results A total of 373 Acinetobacter isolates were collected during the one year period, including 352 A. baumannii isolates and 21 A. lwoffii isolates. The resistance rate of A. baumannii to polymyxin B was 2.6%, which was the lowest. About 15% of A. baumannii isolates were resistant to cefoperazone-sulbactam, imipenem or meropenem. More A. baumannii isolates（37.5 %-59.9% ） were resistant to levofloxacin, piperacillin-tazobactam, cefepime, ampicillin-sulbactam, or piperacillin. More than 60% of A. baumannii isolates were resistant to ciprofloxacin, amikacin, cefotaxime, ceftazidime, trimethoprim-sulfamethoxazole or gentamicin. A. lwoffii were more susceptible to most antibiotics than A. baumannii except polymyxin B. Less than 30% of A. lwoffii isolates were resistant to most antimicrobial agents tested. Conclusions Acinetobacter spp. is one of the most important pathogen in nosocomial infections. Some isolates are highly resistant to most of the commonly used antibiotics.