2004-2008年鲍氏不动杆菌的分布特征及其耐药性变迁分析

Drug Resistance Changes and Clinical Distribution of Acinetobacter baumannii:2004 to 2008 Analysis

目的了解鲍氏不动杆菌的分布及其耐药性变迁趋势,为临床合理选用抗菌药物提供参考。方法回顾性地分析2004-2008年医院临床分离的1034株鲍氏不动杆菌的标本来源及耐药状况。结果鲍氏不动杆菌在老年科检出率最高(44.00%),其次为重症监护病房(18.28%);标本来源以痰液和支气管冲洗液为主,分别占66.83%和11.99%;该菌对亚胺培南耐药率最低(23.02%),其次为氨苄西林/舒巴坦(47.58%)及哌拉西林/他唑巴坦(49.71%);2004-2008年鲍氏不动杆菌的临床分离率及对临床常用的14种抗菌药物耐药率总体呈上升趋势。结论鲍氏不动杆菌分离率和耐药率呈上升趋势,应加强对多药耐药菌的监测和管理、合理使用抗菌药物,预防医院感染发生。

OBJECTIVE To investigate the variations of tendency of clinical distribution and drug resistance of Acinetobacter baumannii（ABA） and provide basis for reasonable use of drugs in clinical practice.METHODS The drug resistance and clinical distribution of 1034 strains of A.baumannii from 2004 to 2008 were retrospectively analyzed.RESULTS The detection rate was highest in senile department（44.00%） among all the departments,then in intensive care unit（18.28%）.The most A.baumannii strains were isolated from sputum（66.83%） and bronchial washing fluid（BWF,11.99%）.The drug resistance rate of ABA to imipenem was the lowest（23.02%）,Ampicillin/Sulbactan（47.58%） and followed by piperacillin/tazobactam（49.71%）.The resistance rate to 15 kinds of drugs appeared increasing trend during from 2004 to 2008.CONCLUSION The isolation rate of A.baumannii is increasing and the resistance rate to drugs appears increasing trend.It is necessary to strengthen the management of multi-drug resistance surveillance,prevent the nosocomial infection and use the antibiotics reasonably.