鲍曼不动杆菌医院感染分布及耐药性分析

Hospital infectious distribution and antibiotic resistance of Acinetobacter baumannii

目的探讨孝感市中心医院鲍曼不动杆菌医院感染的临床分布特点及耐药现状,为临床合理应用抗菌药物提供依据。方法对临床各科室分离出的鲍曼不动杆菌用ATB Expression半自动细菌鉴定仪进行菌种鉴定,采用纸片扩散法进行药物敏感试验。以中华人民共和国卫生部颁布的《医院感染的诊断标准(试行)》为医院感染诊断标准。结果鲍曼不动杆菌以呼吸道标本检出率最高,占67.8%;临床科室中以呼吸科病房及呼吸重症监护室检出率最高,占33.7%。鲍曼不动杆菌对亚胺培南的耐药率最低(2.0%);对头孢哌酮/舒巴坦、阿米卡星、头孢吡肟、米诺环素及头孢他啶有较好的抗菌活性,耐药率较低(≤40.0%);对第1、2代头孢菌素、头孢噻肟、头孢哌酮及氨曲南耐药率均较高(>60.0%);对头孢哌酮/舒巴坦的耐药率(20.0%)低于头孢哌酮(64.4%);对氨基糖甙类中阿米卡星的耐药率(29.3%)低于庆大霉素(73.7%)。结论鲍曼不动杆菌耐药十分严重,应引起临床高度重视。合理使用抗生素,加强医院感染管理,防止耐药菌株导致的爆发流行。

Objective To investigate the character of hospital infectious distribution and antibiotic resistance of Acinetobacter baumannii in Central Hospital of Xiaogan,and to guide the reasonable use of antibacterials in clinic.Methods The Acietobacter baumnii isolated from clinical departments were identificated by ATB Expression semi-automatic bacteria identification instrument,and drug susceptibility test were done with Kirby-Bauer.The standard of diagnosis for nosocomial infections issued by Ministry of Health of the People＇s Republic of China served as the standard of diagnosis of hospital infection.Results The detectablerate of Acietobacter baumnii isolated from respiratory tract was highest（67.8%）,and in clinical departments the detectablerate isolated from respiratory medicine and intensive care unit was highest（33.7%）.Drug resistance rate to Imipenem of Acietobacter baumnii was lowest（2.0%）;To Cefoperazone / Sulbactam,Amikacin,Cefepime,Minocycline and Ceftazidime were lower（≤40.0%）;To the first and second generation Cephalosporin,Cefotaxime,Cefoperazone and Aztreonam were higher （60.0%）;To Cefoperazone / Sulbactam（20.0%） was lower than to Cefoperazone（64.4%）;To Amikacin（29.3%） was lower than to Gentamicin（73.7%）.Conclusion The drug resistance rate of Acinetobacter baumannii was serious,which should arouse more attention in clinic to antibiotic reasonably and to strengthen the administrative work of hospital infection so as to prevent the fulminant epidemic of resistance bacterium.