2007～2008年广州某院肺部鲍曼不动杆菌感染细菌耐药性变迁及临床经验用药与药敏结果相符性分析

Changes in Bacterial Drug Resistance and Consistency between Clinical Empirical Drug Use and Drug Susceptibility Results in Pulmonary Acinetobacter Baumannii Infection in a Hospital in Guangzhou During 2007～2008

目的:分析广州某院2007～2008年间肺部鲍曼不动杆菌感染的细菌耐药性变迁及临床用药与药敏结果相符情况,为临床合理选择抗菌药物治疗鲍曼不动杆菌感染提供参考。方法:选取2007～2008年间住院的148例肺部鲍曼不动杆菌感染患者,统计细菌敏感率。按临床经验用药与药敏结果相符性分相符与不相符2组,比较2组的治疗有效率。结果:鲍曼不动杆菌对各类抗菌药物的耐药性有不同程度的上升,其中亚胺培南敏感率下降至93.02%、头孢吡肟敏感率下降至64.38%、头孢他啶敏感率下降至60.00%等。2007～2008年间,鲍曼不动杆菌对亚胺培南的敏感率最高,其次为丁胺卡那霉素。临床经验用药与药敏结果相符的有100例(占67.57%),其中有效率为94.0%;用药与药敏结果不相符的有48例(占32.43%),其中有效率为50.0%;2组有效率具有非常显著差异(P<0.01)。结论:定期监测鲍曼不动杆菌耐药性变迁,根据药敏结果选用药物,对指导临床防治鲍曼不动杆菌感染具有重要的意义。

OBJECTIVE： To analyze the changes in bacterial drug resistance and the consistency between clinical drug use and drug susceptibility results in the treatment of Acinetobacter baumannii infection in a hospital of Guangzhou during 2007 - 2008 for reference of clinical rational choice of proper antibiotics for Acinetobacter baumannii infection. METHODS： 148 patients with Acinetobacter baumannii pulmonary infection hospitalized during 2007 - 2008 were retrospectively investigated in respect of the bacterial susceptibility and the patients were divided into 2 groups （consistency group and inconsistency group） according to the consistency between clinical empirical drug use and drug susceptibility results, with the responsive rate compared between the two groups. RESULTS： Acinetobacter baumannii＇ s resistance to different types of antibiotics increased in different degree, with its susceptible rates to imipenem, cefepime and ceftazidime dropped to 93.02%, 64.38 % and 60.00%, respectively. Acinetobacter baumannii were most susceptible to Imipenem followed by to amikacin. There were significant differences between the consistent group and the inconstant group [ 100 cases （67.57%） in consistent group vs. 48 cases （32.43%） in inconsistent group] in responsive rate （94.0% for consistent group vs. 50% for inconsistent group） （P 〈 0.01）. CONCLUSION： Periodical monitoring on the drug resistance of Acinetobacter baumannii and rational choice of drugs based on the results of drug susceptibility are of great importance in guiding clinical prevention and treatment of Acinetobacter baumannii infection.