2008-2009年鲍氏不动杆菌临床分布与耐药性分析

Distribution and drug resistance of acinetobacter baumannii from 2008 to 2009

目的分析2008-2009年鲍氏不动杆菌临床分布及耐药性变化,为临床合理使用抗菌药物提供依据。方法收集临床分离的鲍氏不动杆菌,采用Microscan全自动微生物分析仪进行细菌的鉴定及药敏试验,部分药敏试验采用K-B法,应用WHONET 5软件统计数据。结果 2008年鲍氏不动杆菌的分离率为5.33%,2009年鲍氏不动杆菌的分离率为10.41%(P<0.05);痰标本为鲍氏不动杆菌的主要标本来源,ICU为主要病区;2008年除头孢哌酮/舒巴坦、美罗培南、亚胺培南的耐药率<5.00%之外,对其他测试药物耐药率均>25.00%,并呈现多药耐药;2009年所有测试药物的耐药率均大幅上升,显著高于2008年(P<0.05),亚胺培南的耐药率为52.81%,美罗培南的耐药率为40.55%,头孢哌酮/舒巴坦的耐药率为38.53%,其余测试药物耐药率均>50.00%,呈现严重的多药耐药;2008年泛耐药鲍氏不动杆菌(PDR-ABA)的比例为2.94%,2009年PDR-ABA的比例骤然上升至30.16%(P<0.05)。结论鲍氏不动杆菌的分离率及耐药性呈明显上升趋势,耐药形势异常严峻,需引起医院各部门的高度关注。

OBJECTIVE To analyze the distribution and drug resistance of Acinetobacter baumannii from 2008 to 2009,provide the basis for clinical antibiotics application.METHODS The A.baumannii strains isolated from clinical samples were collected,the identification and antimicrobial susceptibility test were determined by Microscan automatic of microorganism identification and antimicrobial susceptibility testing system,some susceptibility tests adopt the Kirby-Bauer method,the data was analyzed by WHONET 5 sofeware.RESULTS The isolating rate of A.baumannii was 5.33% in 2008,the isolating rate of A.baumannii was 10.41% in 2009,（P0.05）.Sputum was the main specimen sources,and ICU was the main endemic area.In 2008,the drug resistance rate of cefoperazone/sulbactam,meropenem and imipenem was below of 5.00%,the drug resistance rate of other drugs exceeded 25.00%,and presented multidrug-resistance.In 2009,the resistance rate of the isolates was significantly exceeded those of isolates in 2008,（P0.05）.The drug resistance rate to imipenem was 52.81%,the drug resistance rate of meropenem was 40.55%,the drug resistance rate of cefoperazone/sulbactam was 38.53%,the drug resistance rate of other drugs exceeded 50.00%,and presented severe multidrug-resistance.The rate of PDR-ABA was 2.94% in 2008,and the rate of PDR-ABA was 30.16%,（P0.05）.CONCLUSION The isolated rate and drug resistant rate of A.baumannii present obviously ascendant tendency,and the rate of PDR-ABA was 30.16% in 2009.The situation is very severe,every department of hospital should pay more attentions to the problems.