鲍曼不动杆菌的临床分布及耐药性分析

Clinical distribution of Acinetobacter baumannii and its resistance

目的了解本院2008年鲍曼不动杆菌的临床分布与耐药情况,为临床抗感染治疗提供依据。方法采用全自动微生物分析仪进行微生物鉴定和最低抑菌浓度MIC测定。对多重耐药菌株采用K-B纸片扩散法进行体外联合药敏实验。结果通过MIC的测定,从98株鲍曼不动杆菌中筛选到了25株多耐药的鲍曼不动杆菌(MDR-Ab)。菌株多来源于重症监护病房和呼吸科。8种常用抗生素中仅亚胺培南耐药率<30%。体外联合药敏实验中头孢哌酮/舒巴坦和米诺环素显示协同或累加作用的16例。结论鲍曼不动杆菌已成为引起院内感染的最常见条件致病菌之一,耐药情况十分严重,应引起临床科室的高度重视;头孢哌酮/舒巴坦联合米诺环素对MDR-Ab引起的感染具有一定的疗效。

Objective To investigate the clinical distribution and resistance of Acinetobacter baumannii （ A. baumannii）collected in Second Affiliated Hospital of General Hospital of PLA in 2008. Methods Microscan 96 automicroscan systems （America） was used to identify the species and determine the minimal inhibitory concentration. The combination antimicrobial susceptibility tests were performed by K-B method for all isolated MDR-Ab. Results A total of 98 strains of A. baumannii were isolated, of which ,25 strains were MDR-Ab. The main strains were from ICU and respiratory department. The resistance rate to imipenem was lower（ 〈 30% ） than that to others. Cefoperazone-sulbactam plus minocycline showed the cooperation or cumulunation effect in 16 cases by combination susceptibility tests. Conclusion Acinetobacter baumannii is a major emerging opportunistic pathogen in hospital, with an increasing multidrug resistance rate. Cefoperazone-sulbactam plus minocycline may be effective for treating the infection caused by MDR-Ab.