长沙地区鲍曼不动杆菌临床分布特征及耐药性分析

Clinical distribution and antibiotic resistance of acinetobacter baumannii in Changsha

目的了解长沙地区鲍曼不动杆菌的临床分布特征及耐药现状,为临床合理选用抗菌药物提供依据。方法收集长沙地区10家综合性医院临床分离的165株鲍曼不动杆菌,采用K-B法检测药物敏感性。结果 165株鲍曼不动杆菌中,154株来自痰及支气管分泌物(占93.4%),其次为伤口分泌物6株(占3.6%)。病区来源以ICU病房最高,占41.2%,其次为神经外科和呼吸科,分别为12.7%和11.0%。在检测的18种药物中,耐药率超过50%的达14种(77.8%),且102株鲍曼不动杆菌呈多重耐药,占61.8%。耐药率最高为哌拉西林(72.5%),其次为头孢噻肟(71.2%)和甲氧苄啶/磺胺甲恶唑(70.0%),耐药率最低为头孢哌酮/舒巴坦(1.2%)。结论临床分离鲍曼不动杆菌多来源于呼吸道标本,以ICU、神经外科和呼吸科为主,且多重耐药现象十分严重。临床应加强对鲍曼不动杆菌耐药性监测,合理选用抗菌药物。

【Objective】 To investigate the clinical distribution and the status of drug resistance of acinetobacter baumannii in Changsha and to provide guidance for rational use of antibiotics.【Methods】 The K-B method was used to detect the drug sensitivity of 165 acinetobacter baumannii isolated from 10 general hospitals in Changsha.【Results】 Among 165 strains of acinetobacter baumannii,154（93.3%） were isolated from sputum and bronchial secretions and 6（3.6%） from wound secretions.Strains isolated from intensive care unit were the most,accounted for 41.2%,and the next were neurosurgery department（12.7%） and respiratory department（11.0%）.Among the 18 antibiotics tested,14（77.8%） had resistant rates higher than 50.0%.102（61.8%） were multi-resistant stains.Resistant rates to piperacillin（72.5%） were the highest,followed by cefotaxime（71.2%） and trimethoprim / sulfamethoxazole（70.0%）.Resistant rates to cefoperazone / sulbactam（1.2%） were the lowest.【Conclusions】 Most of the clinical isolated acinetobacter baumannii were from respiratory specimens.Strains were mainly isolated from intensive care unit,neurosurgery department and respiratory department,and multi-resistant was serious.Monitoring for drug resistance of acinetobacter baumannii should be strengthened,and antimicrobial drugs should be used more rationally.