鲍氏不动杆菌感染分布及耐药性动态变迁

Distribution of Acinetobacter baumannii in Nosocomial Infection and Dynamic Changes in Antimicrobial Resistance

目的了解2005—2007年医院临床分离鲍氏不动杆菌耐药性的动态变迁。方法检测130株鲍氏不动杆菌对临床常用12种抗菌药物的敏感性。结果鲍氏不动杆菌感染主要发生在重症监护病房、呼吸内科和骨科；多药耐药株也同样主要分布在上述3个病区，3年来鲍氏不动杆菌对12种抗菌药物耐药率逐年上升，亚胺培南耐药率在23．1％，其次为头孢哌酮／舒巴坦和氨苄西林／舒巴坦，耐药率分别为30．0％和40．0％，其他抗菌药物耐药率均在56．2％～76．2％；对亚胺培南不敏感的菌株，对头孢哌酮／舒巴坦、氨苄西林／舒巴坦和头孢他啶耐菌率分别56．7％、80．0％和83．3％外，对其他药物耐药率均〉90．0％，而对亚胺培南敏感菌株，对头孢哌酮／舒巴坦和氨苄西林／舒巴坦耐药率分别为22．0％和28．0％，对其他抗菌药物耐药率均在44．0％～71．0％。结论亚胺培南仍是对鲍氏不动杆菌抗菌活性最高的药物。

OBJECTIVE To find out Dynamic changes in Acinetobacter baurnannii of drug resistance from year 2005 to 2007 in the Second Hospital Affiliated to Jiangxi Medial College. METHODS Susceptibility of 130 Acinetobacter baumannii to 12 clinical antibiotics commonly used were detected. RESULTS A. baumannii strains were mainly distributed at ICU wards, respiratory department and Orthopedics department, sameas the Multi-drug resistance strains. The resistance rate of A. baumannii isolates to 12 antimicrobial agents has been on a steady increase in the past 3 years, among which the resistant rate of Imipenem was 23. 1%, cefoperazone/sulbactam and ampicillin/ sulbactam were 30.0% and 40.0% respectively, and other antimicrobial agents were from 56.2% to 76.2% . The strains not susceptible to imipenem had resistant rates to cefoperazone/sulbactam, ampicillin/sulbactam, and ceftazidime which were 56.7%, 80.0%, 83.3% respectively. To other agents, the rates were over 90.0% on the average. But the strains susceptible to imipenem had resistant rates to cefoperazone/sulbactam, ampicillin/ sulbactam which were 22.0%, 28.0% respectively. To the other agents the rates were from 44.0% to 71.0%. CONCLUSIONS The resistance of A. baumannii has been rising steadily. Imipenem is still the most active drug in A. baumannii, followed by Cefoperazone/sulbactam.