2005～2008年临床分离鲍氏不动杆菌耐药趋势的分析

Antimicrobial Resistance of Clinical Isolates of Acinetobacter baumannii 2005-2008:A Trend Analysis

目的了解临床分离鲍氏不动杆菌的耐药性变迁,为临床抗感染治疗及合理使用抗菌药物提供依据。方法采用微量肉汤稀释法测定13种抗菌药物的最低抑菌浓度(MIC)。结果4年共分离鲍氏不动杆菌956株,83.7%来源于呼吸道标本,分离的细菌数逐年增加,鲍氏不动杆菌对13种抗菌药物的耐药率总体呈上升趋势;特别是鲍氏不动杆菌对亚胺培南、美罗培南耐药率由2007年的5.7%、6.2%,增加到2008年22.9%、23.1%,多药耐药株、泛耐药株由6.5%、0,增加到23.0%、5.1%;头孢哌酮/舒巴坦4年的耐药率均<20.0%;4年碳青酶烯类抗菌药物的年用药频度与耐药率关系的分析显示,随用药频度的增加耐药率有明显增高。结论鲍氏不动杆菌的耐药率在不断上升,特别是多药耐药和泛耐药株的增多,因此应慎重、合理地使用碳青酶烯类抗菌药物,密切关注鲍氏不动杆菌耐药的发展,采取有效的感染控制措施。

OBJECTIVE To investigate the clinical isolates of Acinetobacter baumannii （ABA） resistance and their changes, and provide the basis for the clinical anti-infection treatment and the reasonable antibiotic use. METHODS Broth microdilution method was made to determine the minimum inhibitory concentration （MIC） of 956 isolated ABA from the Tianjin First Central Hospital 2005--2008. RESULTS Among 956 isolates, 83. 7% were from respiratory tract specimens, The rate of isolation increased year-on-year and the resistance rate to 13 kinds of antibiotics tended upward in overall. In particular, the resistant rate to imipenem, and meropenem 5. ？ % and 6.2% was from in 2007 to 22.9%, and 23.1% in 2008;and that of multi-drug resistant strains, and panresistant strains was increased from 6.5% and 0 in 2007 to 23.0% and 5.1% in 2008. During the last 4 years the resistance rate to cefoperazone/sulbactam as all less than 20. 0%. Carbapenem antibiotics DDDs year analysis showed that with the increase in the frequency of drug the resistance increased significantly. CONCLUSIONS The resistance rates of A. baumannii are rising, especially multi-drug resistance and pan-resistant strains increase. So we should be careful and rational use of antimicrobial carbapenem drugs, pay close attention to the development of drug-resistant A. baumannii, and effective infection control measures.