心血管病专科医院临床分离不动杆菌属细菌分布及耐药性分析

Distribution and drug-resistance of Acinetobacter spp.isolated from a cardiovascular hospital

目的了解某心血管病专科医院临床分离的不动杆菌属细菌分布特点及其对常用抗菌药物的耐药情况。方法回顾性分析该院2006年1月-2009年12月分离的不动杆菌属细菌的资料。结果 409株不动杆菌属细菌标本分布:主要分离自痰标本,占75.79%,其次为血液标本8.56%,其他标本(尿、深静脉插管、分泌物)15·65%;科室分布:以外科重症监护室(ICU)检出最多,占40.59%,其次为内科ICU 37.41%,其他内/外科普通病房22.00%;菌种分布:鲍曼不动杆菌检出最多,占80.20%,其次为洛菲不动杆菌16.87%,溶血不动杆菌2.93%。不动杆菌属细菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、庆大霉素、阿米卡星、环丙沙星的耐药率低,分别为2.69%、14.18%、19.56%、15.16%、15.65%、9.29%和14.18%;对亚胺培南和美罗培南耐药率分别为3.67%和5.87%;对其他抗菌药物的耐药率均>57%。结论不动杆菌属细菌是引起医院感染的非发酵病原菌之一,以呼吸道感染为主,对现有抗菌药物耐药严重。头孢哌酮/舒巴坦、碳青霉烯类抗生素是治疗不动杆菌属细菌感染的有效药物。

Objective To investigate the characteristics of the distribution and drug-resistance of Acinetobacter spp. in a cardiovascular special hospital. Methods The distribution and drug resistant rates of Aclnetobacter spp. which isolated from clinical specimens from January, 2006 to December, 2009 were analysed retrospectively. Results 409 Acinetobacter spp. were mainly isolated from sputum（75.79%）, followed by blood（8. 56%）, the rest from others（urine,venous catheter,secretions） and accounted for 15.65%; department distribution ： Acinetobacter spp. were mainly isolated from surgical ICU and accounted for 40. 59%, followed by medical ICU and accounted for 37. 41%,other departments（including surgery and internal medicine） was 22. 00% ; bacteria distribution： Acineto bacter spp. consisted of Acinetobacter baumannii （80. 20 % ）, followed by Acinetobacter lwoffii （ 16. 87% ） and Acinetobacter haemolyticus （2. 93%）. Acinetobacter spp. had low drug-resistant rates to cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime, cefepime,gentamycin, amikaein and eiprofloxacin, drug-resistant rate was 2. 69%, 14. 18%, 19. 56%, 15.16%,15.65%, 9.29%, and 14. 18%, respectively. The percentage of drug-resistant rate to imipenem and meropenem was 3. 67% and 5.87% respectively, while it was over 57% to the other antimicrobial agents. Conclusion Acinetobacter spp. is one of non-fermentative bacteria in nosocomial infection, the main infection is respiratory tract infection , and shows serious drug-resistance. Cefoperazone/sulbactam and carbapenems are effective antibiotics for treating infections caused by Acinetobacter spp..