2005～2008年鲍氏不动杆菌的耐药性变迁分析

Drug-resistance Analysis of Acinetobacter baumannii 2005-2008

目的了解鲍氏不动杆菌的感染分布及耐药性变迁情况,为临床治疗及预防提供依据。方法回顾性分析2005年1月-2008年12月临床标本中分离的292株鲍氏不动杆菌的临床感染特点及其药敏结果。结果鲍氏不动杆菌感染临床分布以重症监护病房及呼吸科居多,临床标本中以呼吸道标本分离率最高,占81.5%;体外药敏试验结果显示：4年间鲍氏不动杆菌对13种临床常用抗菌药物的耐药率总体呈先上升后下降趋势,到2008年,哌拉西林、哌拉西林/他唑巴坦、头孢他啶、氨苄西林/舒巴坦、亚胺培南、复方新诺明、环丙沙星、美罗培南、头孢吡肟等耐药率均〉50.0%;介于30.0%-50.0%的有阿米卡星、妥布霉素,多黏菌素E的耐药率最低,为4.9%。结论鲍氏不动杆菌对抗菌药物存在多药耐药性,该菌耐药率高,临床上应根据其临床分布特点和药敏试验结果选用合理抗菌药物。

OBJECTIVE To investigate the clinical distribution and drug resistance changes of Acinetobacter baumannii in the Second People′s Hospital of Wenzhou and provide evidence for proper choose of antibiotics.METHODS The result of drug susceptibility and clinical distribution of A.baumannii from Jan 2005 to Dec 2008 in our hospital were analyzed and studied retrospectively.RESULTS A.baumannii was distributed mainly in ICU and respiratory medicine ward.The isolation rate was the highest in the respiratory specimens,up to 81.5%.The result of drug sensitive test showed that there was an elevated first and then lowered tendency of resistance rates to 13 commonly used antibiotics during the past 4 years.In 2008,the resistance rates to the most antibiotics including piperacillin,piperacillin/tazobactam,ceftazidime,ampicillin/sulbatam,imipenem,sulfamethoxazole/trimethoprim,ciprofloxacin,meropenem,cefepime,etc were higher than 50.0%.For amikacin and tobramycin,the drug resistance rates were 30.0% to 50.0%.Polymyxin E had the lowest drug resistance rate of 4.9%.CONCLUSIONS A.baumannii has multiple drug resistance and has high resistance rate.It is necessary to choose the antibiotics sensitive to A.baumannii according to the clinical distribution and the result of drug sensitive test.