878株鲍曼不动杆菌的耐药分析及流行调查

Resistance Analysis and Epidemiological Survey of 878 Acinetobacter Baumannii Solates

目的调查鲍曼不动杆菌的分布、耐药变迁,分析耐药谱,为临床治疗提供有效的实验室依据,防范院内感染.方法回顾性分析2008年1月至2011年6月临床分离的鲍曼不动杆菌的分布、耐药情况及以氨曲南(ATM、A)、氨苄西林(AMP、P)、环丙沙星(CIP、C)、美罗培南(MEM、M)、头孢他(CAZ、F),亚胺培南(IPM、I)组合的耐药谱表型.结果 3 a半共检出鲍曼不动杆菌878株,呼吸道标本占84%;ICU为主要分布科室;感染率逐年上升.鲍曼不动杆菌对分析的16种临床常用抗生素的耐药率逐年上升,其中亚胺培南和美罗培南的耐药率分别高达:84.4%、87.5%.经抗生素耐药谱统计共发现67种耐药表型在我院流行,其中以抗生素谱:(1)"APC-FI"(ATM、AMP、CIP、CAZ、IPM:均耐药,MEM:未测定);(2)"APCMFI"(ATMAMPCIPMEMCAZIPM均耐药")为主,感染率分别为:19%及15%.结论鲍曼不动杆菌感染率逐年升高,对常用抗生素耐药率继续呈现上升趋势,耐药谱"APC-FI"、"APCMFI"在我院广泛流行.

Objective To provide effective laboratorial proof and control hospital infection by investigating the distribution and drug resistance of Acinetobacter baumannii and analyzing resistance profiles.Method The distribution,drug resistance and resistance profiles including Aztreonam（A）,Ampicillin（P）,Ciprofloxacin（C）,Meropenem（M）,Ceftazidime（F）and Imipenem（I）of Acinetobacter baumannii clinical isolates in our hospital from Jan.2008 to Jun.2011 were reviewed and analyzed by WHONET 5.5 software.Results 878 Acinetobacter baumannii strains were found,in which 84% were respiratory tract specimens,and most strains were in ICU.Acinetobacter baumannii ＇s infection rate and drug resistance rates to 16 clinical common antibiotics was rising year by year,particularly resistance rates to Imipenem and Meropenem were up to 84.4% and 87.5% respectively.Resistance profiles of Acinetobacter baumannii had 67 kinds,in which three phenotypes：（1） ＂APC-FI＂（ATM,AMP,CIP,CAZ,IPM：all resistance,MEM： not determined）,（2） ＂APCMFI＂（ATM,AMP,CIP,MEM,IPM all resistance were mainly phenotypes.The infection rate of the two phenotypes was 19%,and 15%,respectively.Conclusion Infection rate of Acinetobacter baumannii is rising year by year,its resistant rates to common antibiotics show an upward trend and new phenotype start to prevalent.