2007-2009年鲍氏不动杆菌临床分布及耐药性分析

Antibiotics resistance and clinical distribution of acinetobacter baumannii during 2007-2009

目的监测医院2007-2009年临床标本鲍氏不动杆菌的分布特点及其耐药性。方法回顾性分析2007年1月-2009年12月,从患者不同标本分离鲍氏不动杆菌,采用NCCLS标准K-B法对临床常用抗菌药物进行耐药分析,了解其耐药变迁。结果 2007-2009年共分离鲍氏不动杆菌857株,在革兰阴性杆菌中鲍氏不动杆菌约占19.51%;857株鲍氏不动杆菌临床分布主要以患者痰标本为主,分布率为83.31%;科室分布主要是重症监护病房(ICU)居首位,分布率为52.86%;除多黏菌素、头孢哌酮/舒巴坦保持较高的敏感性,其他药物耐药率均>57.0%,而且耐药率逐年增高,发现224株泛耐药菌株。结论鲍氏不动杆菌有很强的耐药性,给治疗带来许多困难,应加强医院环境和人员消毒,防止鲍氏不动杆菌的播散;临床医师应根据耐药率变化选择敏感药物或采取联合用药,既可有效治疗鲍氏不动杆菌感染又能有效防止或减慢耐药菌株的形成。

OBJECTIVE To investigate the clinical distribution and drug resistance of Acinetobacter baumannii in hospital from 2007 to 2009.METHODS A.baumannii isolated from patients,specimens between Jan 2007 and Dec 2009 were retrospectively analyzed.The antibiotics susceptibility were detected by K-B test according to NCCLS standards,the variation of drug resistance was analyzed.RESULTS A total of 857 strains of A.baumannii were isolated from last three years,A.baumannii in gram-negative bacilli accounted for 19.51%,which mainly came from the sputum samples of patients,accounting for 83.31%.In the distributions of the departments in hospital,the intensive care unit（ICU） was the most,with the rate of 52.86%.In addition to polymyxin and cefoperazone sulbactom,the drug resistance rates were all above 57.0%,which increasing year by year and 224 pan-resistant strains were found.CONCLUSIONS A.baumannii has a high drug resistance which can bring many difficulties to the treatment.The hospital environment and personnel disinfection should be strengthened to prevent the spread of A.baumannii.The sensitive drugs should be chosen based on the change of drug resistance and combination of drug application,which can effectively treat the infections caused by A.baumannii and prevent or slow down the formation of resistant strains.