耐亚胺培南/西司他丁鲍曼不动杆菌的分离及耐药性

Isolation and antimicrobial resistance of imipenem/cilastatin-resistant Acinetobacter baumannii

目的了解耐亚胺培南/西司他丁(IPM)鲍曼不动杆菌(Ab)在某院的分离及其耐药性。方法收集该院2006年1月—2010年12月临床各类标本,除血培养采用美国BD公司BACTEC9120进行检测,其余标本按常规方法培养分离细菌;在Phoenix 100全自动分析系统和配套试剂中,对菌株进行鉴定及药敏试验。采用2-巯基丙酸抑制试验测定金属酶。结果检出154株耐IPM的Ab,主要分离自痰及咽拭子标本,占74.03%;科室分布:主要分布于重症监护室(98株,63.64%)、神经科(25株,16.23%)、烧伤科(13株,8.44%)、呼吸内科(8株,5.19%)、老年内科(4株,2.60%)、普通外科和血液科(各3株,1.95%)。耐IPM的Ab对头孢哌酮/舒巴坦耐药率最低,为42.21%;对其他抗菌药物的耐药率均>65%。耐IPM的Ab产金属酶率为14.94%(23/154)。结论耐IPM的Ab主要来源于呼吸道感染标本,对抗菌药物敏感率较低。加强监控和优化抗菌药物的使用,对控制耐IPM的Ab在医院内流行有重要意义。

Objective To study the isolation and antimicrobial resistance of imipenem/cilastatm （IPM）-reslstant Acinetobacterbaurnannii （A. baumannii） in a hospital. Methods Clinical specimens were collected from January 2006 to December 2010, except the blood culture was performed with United States BI） BACTEC9120 system, the other specimens were euhured and isolated bacteria with routine method ; strains were identified and performed drug sensitive test with Phoenix 100 automatic analysis system and reagents. The metallo-β-lactamase were detected with 2-mercaptopropanoic acid inhibited assays. Results One hundred and fifty four （74. 03%） IPM resistant A. baumannii strains were mainly isolated from sputum and throat swabs, strains mainly distributed in the following departments： intensive care unit （98 isolates,63.64%）, department of neurology （25,16. 23%）, burn unit （13, 8.44%）, respiratory department（g, 5. 19%）, geriatrics department （4, 2, 60%）, department of general surgery （3,1.95%）, and hematological department（3,1.95%） . 1PM resistant A. baumannii had the lowest resistant rate to eefoperazone/sulbactam （42.21%）, and the resistant rates to the other antimicrobial agents were all 〉65 X. The rate of metallo %lactamase-producing strains was 14. 94%（23/154）. Conclusion The IPM-resistant A. baumannii are chiefly from specimens in respiratory tract infection, and the susceptibilky to antimicrobial agents is low. The gtrengthening of the monitor and optimization use of antimicrohial agents is important for controlling the prevalence of IPM-resistant A. baumannii in hospilals.