2007-2009年鲍氏不动杆菌的耐药性变迁及临床对策

Change of Acinetobacter baumannii Resistance and Clinical Strategies from 2007 to 2009

目的了解2007年1月-2009年12月温州市第三人民医院ICU鲍氏不动杆菌的耐药变迁,为临床经验性选择抗菌药物提供依据。方法采用美国DADE公司的Mierosean Autoscan-4型微生物分析仪对细菌进行鉴定并做药敏试验。结果鲍氏不动杆菌的分离率逐年升高趋势,以痰标本分离最多,占总分离菌的85.80%,泛耐药菌株分离率分别为4.50%、6.14%、7.09%;头孢哌酮/舒巴坦是所有被监测药物中对352株鲍氏不动杆菌抗菌作用最强的抗菌药物,头孢哌酮/舒巴坦的耐药率约43.31%,对亚胺培南耐药率达87.40%,鲍氏不动杆菌多药耐药严重,对临床常用抗菌药物的耐药性呈逐年上升趋势。结论应加强鲍氏不动杆菌耐药性监测,了解其耐药变迁,指导临床合理用药,防止耐药菌株的传播。

OBJECTIVE To investigate the changes of antimicrobial resistance among Acinetobacter baumannii isolated from the patients in Wenzhou Third People＇s Hospital from Jan 2007 to Des 2009.METHODS The samples of Bacterial pathogens were identified and detectived by MicroscanAutoscanner-4.The vitro antibiotic resistance of all the isolates from the samples was analyzed.RESULTS The antimicrobial resist Acinetobacter increased year by year.85.8% of the A.baumannii were isolated from the sputum.The pan-resistant strains accounted for 4.6%,6.14%,and 7.09% respectively.Cefoperazone and Sulbactam was the most active antibiotics tested against A.baumannii.Cefoperazone/Sulbactam.87.40% of A.baumannii resistance to imipenem.CONCLUSION It is important to guide the rational drug use in the clinic to strengthen the monitoring of the antimicrobial resistance A.baumannii,to investigate the change of the antimicrobial resistance and guide the rational drug application in clinics can prevent bacterial strains of drug resistance from being transmitted.