鲍曼不动杆菌医院感染状况及耐药性分析

Stauts of nosocomial infection of Acinetobacter baumannii and drug resistance

目的了解鲍曼不动杆菌(Acinetobacter baumanmii,Aba)医院感染现状及其对临床常用抗菌药物的耐药情况,以指导临床更有效地使用抗生素。方法按常规方法对住院病人的各种临床标本进行细菌培养和分离,VITEK-II全自动微生物鉴定仪进行鉴定,按当年度CLSI的标准用纸片扩散(K-B)法对临床常用的抗菌药物进行药物敏感性试验,采用whonet5.3软件对数据进行统计处理。结果共分离出161株Aba,主要来源于痰、咽拭子、分泌物及血,分别占68.9%(111/161)、10.6%(17/161)及7.5%(12/161);Aba分布居前3位依次为ICU占30.4%(49/161)、呼吸内科占16.1%(26/161)和神经内科占13.7%(22/161);其对17种常用抗生素的耐药率为亚胺培南11.8%、美诺培南8.1%,对头孢他啶、头孢吡肟、左氧沙星的耐药率均小于50.0%,而对其余抗菌药物耐药率均在50.0%以上。结论Aba院内感染部位主要为呼吸道。Aba对大多数临床常用抗生素呈现出多重耐药,亚胺培南及美诺培南是治疗该菌感染最为有效的药物。

Objective To survey the nosocomial infection and antibiotic - resistant of Acinetobacter baumannii. Methods Strains of Acinetobacter baumannii were isolated and cultured in routine procedures, and identified by VITEK - Ⅱ. Antibiotic Susceptibility Test （AST） were conducted by disc- diffusion （K- B） method, the results were determined according to guidelines from NCCLS （ National Committee Clinical Laboratory Standards）. And whonet 5.3 software were used to deal with the data. Results There 161 Acinetobacter baumannii strains were detected, mainly isolated from the spucutum（68.9%, 111/161）, the secrecion（10.6%, 17/161） and the blood prepration （7.5%, 12/161）. The first three sites of distribution of Acinetobacter baumannii were ICU（ 30.4 % ,49/161 ）, department of respiratory（ 16.1%, 26/161 ） 和 department of neurology（ 13.7 %, 22/161 ）. Among 17 antibiotics frequently used, the resistant rate of Acinetobacter baumannii to imipenem was 11.8%, and 8.1% to Meropenem, and the resistance to ceftazidime, cefepime and levofloxacin was 〈 50.0%, but exceeded 50.0% to all the other agents. Conclusion Acinetobacter baumannii is multi - resistant to most antimicrobial agents. Imipenem and Meropenem are the two most effective drugs for treatment of Acinetobacter baumannii infection.