下呼吸道感染不动杆菌属流行及耐药现状分析

Epidemic Status of Acinetobacter ssp. in Lower Respiratory Tract Infection and Their Drug Resistance

目的了解下呼吸道感染不动杆菌属的流行情况及耐药现状,为临床合理选用抗菌药物提供依据。方法用WHONET5.4软件统计分析2006-2007年医院住院患者痰液标本培养结果为不动杆菌属的数据,率的比较用u、χ2检验。结果2006、2007年全院不动杆菌属菌株所占比例分别为9.2%、7.4%,脑外科、外科ICU、急诊ICU的检出率明显高于全院平均水平;不动杆菌属对亚胺培南的敏感率最高两年分别为85.3%、72.9%,两年间比较,亚胺培南、美罗培南的耐药率显著增高,头孢哌酮/舒巴坦的敏感率增高;不动杆菌属对部分三、四代头孢菌素、氨基糖苷类、左氧氟沙星及氨曲南等敏感率均<50.0%。结论不动杆菌属耐药现象严重,耐药机制较为复杂,单一用药推荐碳青酶烯类,可根据临床及药敏结果考虑联合用药。

OBJECTIVE To investigate the epidemic situation of Acinetobacter in lower respiratory tract infection and their drug resistance, in order to provide evidence for clinical anti-infection therapy. METHODS The data of Acinetobacter from the sputum specimens of inpatients in our hospital with lower respiratory tract infection during 2006-2007 were collected and analyzed with the software the software WHONET5. 4. RESULTS Among all pathogens in lower respiratory tract infection, Acinetobacter accounted for 9.2 % in 2006 and 7.40% in 2007, the rate in deparment of neurosurgery, surgical ICU and respiratory ICU was higher. Acinetobacter had the highest susceptible rate to imipenem and were also susceptible to meropenem and cefoperazone/sulbactam. However, Acinetobacter had higher resistant rate to imipenem and meropenem while higher susceptible rate to cefoperazone/ sulbactam in 2007 than in 2006. The susceptible rate of Acinetobacter to the third and forth generation cephalosporins, amikacin, levofloxacin and aztreonam was lower than 50%. CONCLUSIONS The drug resistance mechanism of Acinetobacter is so complicated that many kinds of drugs prove poorly effective. Carbopenems are recommended when single drug is utilized and drug combination based on the clinical and laboratory information can be tried.