鲍曼不动杆菌临床分离率与耐药率的分析

Analysis on clinical isolation rate and resistace rate of Acinetobacter baumannii

目的 了解2005～2009年鲍曼不动杆菌在临床标本中的分离情况及其耐药趋势,为临床感染的预防和治疗提供参考资料.方法 回顾分析2005～2009年间所有标本中鲍曼不动杆菌的分离率,菌株在标本与病区的分布及对15种抗菌药物的耐药率.结果 鲍曼不动杆菌的分离率有逐年升高的趋势,从2005年的0.39增至2009年的1.39;其在呼吸道标本的分离率最高（61.69%）,其次是尿液（11.3%） ;病区分布以重症监护室（ICU）最高（44.48%）;鲍曼不动杆菌对15种抗菌药物的耐药率在2005年仅有五种〉50%,而到2009年仅头孢哌酮/舒巴坦的耐药率〈50%,其他14种耐药率均〉50%;其耐药率均呈递增的趋势,耐药性增幅列前3位的分别是：环丙沙星38.1%～76.3%、妥布霉素29.4%～78.3%、庆大霉素39.2%～80.1%.结论 鲍曼不动杆菌的临床分离率在逐年增加,其对多数抗菌药物有较高的耐药性,且耐药率呈逐年上升趋势,尤其是对亚胺培南耐药率的快速增长,应引起临床抗感染治疗的高度重视.

Objective To study the isolation and resistance tendency of Acinetobacter baumannii to antimierobial agents from 2005 to 2009 to provide valuable data for infection prevention and therapy. Methods The review analyzes during for 2005- 2009 years in all specimens Acinetobacter baumarmii separative rate, the strain bears the medicine rate in the specimen and the ward distribution and resistance rate to 15 kinds of antimicrobial agent. Results There was an increasing tendency of isolation rates of Acinetobacter baumannii every year, which was 0.39 in 2005 but 1.39 in 2009. In the five years, there was the highest isolation rate of 61.69 % in specimens from respiratory tract, the next was from the urine（ 11.3 % ）. Concerning the wards distribution. ICU had the highest rate of 44.48 %. In 2005, Acinetobacter baumannii had resistance rates more than 50 only to five kinds of antimicrobial agents, but in 2009, it had increased to fourteen kinds （except cefoperazone/sulbac- tam）. About the fiveteen kinds of antimicrobial agents we inspected, that were increased in their resistance rate. The highest increasing of resistance rate was Ciprofloxacin from 38.1% in 2005 to 76.3% in 2009,Tobramycin was second for 29.4% to 78.3% ,and the third was Gentamicin fore 39.2 % to 80.1%, while there still was an increasing resistance tendency to them. Conclusion Aeinetobacter baumannii clinical separative rate is increasing year by year, it has the high drug resistance to the most antibiotics, also bears the medicine rate to assume year by year the trend of escalation south, cultivates in particular to the imines bears the medicine rate fast growth, should cause the clinical anti - infection treatment to take highly.