306株鲍曼不动杆菌的临床分布及耐药性监测

Distribution and surveillance of antimicrobial resistance on 306 strains of Acinetobacter baumannii infection

目的调查杭州市某医院鲍曼不动杆菌感染的临床分布及其耐药性现状。方法监测该院2004年1月至2006年12月临床分离的306株鲍曼不动杆菌的临床感染分布及耐药性,药物敏感试验采用琼脂纸片扩散法,耐药性数据分析采用WHONET 5软件。结果2004年至2006年3年间,鲍曼不动杆菌的检出率呈逐年增加趋势(从1.60%增至2.40%);临床分布以重症监护室(ICU)最高(84/306),老年患者多见(131/306);有184株(60.13%)来源于痰液标本。药敏试验结果显示鲍曼不动杆菌对美罗培南最敏感,耐药率为4.6%;其次是亚胺培南/西司他丁和头孢哌酮/舒巴坦,耐药率分别为7.2%及8.5%;对3代头孢菌素及环丙沙星的耐药率均>50.0%;同时发现185株(60.5%)为多重耐药菌株。结论鲍曼不动杆菌对碳青霉烯类抗生素及头孢哌酮/舒巴坦较敏感,临床医师应注意合理使用抗菌药物,以减少多重耐药菌株的产生。

Objective To investigete the distribution and antimicrobial resistance of A. baumannii infection from a hospital in Hangzhou. Methods Antimicrobial resistance of 306 strains of A. baumannii isolated from clinic infection from January 2004 to December 2006 in a hospital was surveyed. Disc diffusion test （K-B method） was used to study the antimicrobial resistance. The data were analyzed by WHONET 5 software. Results There was an increasing tendency （from 1.60% to 2.40% ） of isolation rates on A. baumannii in 2004,2005 and 2006 respectively. The intensive care unit （ICU） had a highest rate of A. baumannii （84/306） in clinic distribution, and 131 strains of A. baumannii （42.81% ） were isolated from old sufferers. Among 184 strains of A. baumannii infection （60.13% ） were frosputum. A. baumannii had the highest susceptibility to meropenem, the resistant rate to meropenem was the lowest （4.6%）, followed by imiperie cilastatin （7.2%） and cefoperazone-sulbactam （8.5%） ;the resistant rates of the strains to the third generation cephalospoIin and ciprofloxacin were both more than 50.0% ;185 strains of A. baumannii （60.5%） were multi-resistant to antimicrobial agents. Conclusions The isolates of A. baumannii were susceptible to carbapenems and cefoperazone/sulbactam. Antimicrobial agents should be used rationally to decrease multi-drug resistance.