2007-2009年鲍氏不动杆菌的耐药性分析

Drug resistance of acinetobacter baumannii between 2007 and 2009

目的了解鲍氏不动杆菌耐药性的变迁,为临床合理用药提供依据。方法回顾性分析2007-2009年临床分离的1318株鲍氏不动杆菌药物敏感结果,细菌鉴定和药物敏感试验采用法国生物梅里埃公司VITEK-2全自动微生物分析仪。结果鲍氏不动杆菌主要来自ICU,占24.7%,其次为呼吸内科,占19.3%;标本来源主要为痰,占43.2%,其次为尿液,占13.8%;鲍氏不动杆菌对多种常见抗菌药物耐药率较高,除阿米卡星和妥布霉素耐药率近年来有下降趋势外,多种抗菌药物耐药率呈上升趋势;对其敏感性较好的抗菌药物有哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南、美罗培南和阿米卡星。结论鲍氏不动杆菌多药耐药现象严重,临床应根据药敏结果合理用药,注意消毒与隔离,控制耐药株的流行。

OBJECTIVE To investigate the resistance of Acinetobacter baumannii and provide basis of proper application of antibiotics for clinical treatment. METHODS A total of 1318 isolates of A. baumannii were obtained retrospectively from clinical patients in the first clinical college of harbin medical university between 2007-2009. Both the identification and the drug sensitivity of bacteria to antibiotics were determined by VITEK-2 （Bio Merieux）. RESULTS A. baumannii were obtained mainly from ICU ward（24.7%）, and the next was respiratory ward （19. 3%）. Among all the specimens, sputum accounted for 43. 2%, and then the urine （13. 8%）. The resistant rates to the most common antimicrobial agents were very high, except sulperazone, piperacillin/ tazobactam, imipenem, meropenem and amikacin. Except amikacin and tobramycin, the resistant rates to most of other detected antibiotics had increasing tendency. CONCLUSION The drug resistance of multi-drug resistant A. baumannii is very serious. It is important to select proper antibiotics according to the results of antibiotics susceptibility tests, the sterilization and isolation should be paid attention and the prevalence of multi-drug resistant isolates should be controlled.