2006-2009年常宁市鲍曼不动杆菌的临床分布及耐药分析

Clinical Distribution and Drug Resistance of Acinetobacter baumanii from 2006 to 2009

目的了解鲍曼不动杆菌在医院临床感染中的分布及其耐药情况,为临床合理用药提供实验依据。方法回顾性分析某医院2006年1月-2009年12月住院患者1796份标本的鲍曼不动杆菌分离检出及耐药情况。结果 1796份标本中共分离出鲍曼不动杆菌278株,检出率为15.48%,主要从痰液、脓液及分泌物中检出,其检出率分别为57.11%(233/408)、7.77%(30/386),主要集中于呼吸内科和神经外科等科室;对多粘菌素E、头孢哌酮/舒巴坦、美洛培南及亚胺培南较敏感,其耐药率分别为36.33%、38.49%、39.21%,对于其他抗菌药物的耐药性均较高,但4年的耐药监测还没有发现基因突变型耐药。结论鲍曼不动杆菌在医院感染的发生率高,耐药较为严重,临床应根据药敏结果合理用药,减少耐药株的产生。

Objective To investigate the clinical distribution and drug resistance of infection due to Acinetobacter baumanii in Changning Hospital of Traditional Chinese Medicine,and to provide the evidence for rational drug therapy.Methods Clinical distribution and drug resistance of Acinetobacter baumanii,which were selected from 1,796 inpatients＇ specimens in Changning Hospital of Traditional Chinese Medicine from January,2006 to December,2009,were retrospectively analyzed.Results Among the 1,796 clinical specimens,278 strains of A.baumanii were isolated,with the detection rate of 15.48%.A.baumanii was mainly obtained from sputum（57.11%,233/408）,pus and secretions（7.77%,30/386）,and most of them were detected from department of neurosurgery and department of respiratory medicine.A.baumanii was sensitive to polymyxin E,cefoperazone/sulbactam,imipenem and meropenem,the resistance rates were 36.33%,38.49%,and 39.21%,respectively.The resistance rates to the other common antimicrobial agents were more than 50.0%.Many strains showed multi-drug resistance,but without genotype drug resistance.Conclusions The incidence rate of A.baumanii infection is highly prominent,and moreover,its drug resistance and multiple drug resistance are serious.Antimicrobial treatment to A.baumanii？infection should be guided by drug sensitivity test.