ICU获得性鲍曼不动杆菌肺炎及耐药性变化趋势

Analysis of Hospital-acquired Pneumonia caused by Acinetobacter Baumannii and Drug-resistance in ICU

目的:对ICU获得性鲍曼不动杆菌肺部感染及耐药性变化趋势进行分析,为临床治疗提供参考。方法:回顾性分析我院ICU2007年1月至2009年12月获得性鲍曼不动杆菌肺部感染及药敏结果。结果:共分离出74株鲍曼不动杆菌,2007年分离率为6.5%(14/215),2008年为10.1%(22/218),2009年为12.0%(38/316),呈增加趋势(P<0.05);药敏结果显示碳青霉素类、头孢哌酮/舒巴坦钠耐药率3年内均保持在50%以下;阿米卡星耐药率保持在30%以下;左旋氧氟沙星前二年耐药率在15%以下,2009增加至52.6%;对其余抗生素的耐药率超过了50.0%以上,多重耐药性明显。结论:ICU获得性鲍曼不动杆菌肺炎的发生呈增加趋势,耐药率较高且有多重耐药现象。应重视该菌感染及耐药性监测,预防医院感染的发生。

Objective:To analysis of hospital-acquired pneumonia (HAP) caused by Acinetobacter baumannii and drug-resistance in ICU,to provide evidence of clinical therapy.Methods:The data of HAP due to Acinetobacter baumannii and its sensitivity to antibiotics from Jan 2007 to Dec 2009 were analyzed retrospectively.Results:During the 3 years,74 strains of Acinetobacter baumannii were isolated.The isolating rate was 6.5%(14/215)in 2007,10.1% (22/218)in 2008,12.0%(38 /316)in 2009,the isolating rates increased significantly (P<0.05).The resistant rates to carbapenem,cefoperazone/sulbactam sodium,amikacin were under 50%,50%,30% during 3 years respectively. The resistant rates to levofloxacin was under 15% in the first two years,though 52.6% in 2009.The resistant rates to the other common antibiotics was more than 50.0%.The moreover strains showed multi-drug resistance.Conclusion: The incidence of HAP caused by Acinetobacter baumannii increased significantly.There were many Acinetobacter baumannii to multiplex antimicrobial angents.We must keep monitoring of Acinetobacter baumannii infection and drugresistant changes in order to prevent nosocomial infections.