2010年住院患者鲍曼不动杆菌的耐药性分析

Drug resistance analysis of acinetobacter baumanii from inpatients in 2010

目的了解我院住院患者的鲍曼不动杆菌的分布特点及耐药情况,为临床治疗提供可靠依据。方法采用法国生物梅里埃公司VITEK 2 Compact系统进行细菌鉴定,K-B法进行药敏试验,使用WHONET 5.4软件进行细菌的耐药性分析。结果我院鲍曼不动杆菌检出率为6.62%,出现最多是痰标本,占81.16%;鲍曼不动杆菌感染主要以康复科、神经科及ICU最多,其次为呼吸内科。该菌对头孢哌酮/舒巴坦和米诺环素的敏感性最高,均在80%以上,对美洛培南和亚胺培南的敏感率均在60%以上,对其它抗菌药物的耐药率在50%以上。结论鲍曼不动杆菌是医院感染重要的条件致病菌,其对抗生素耐药率高,且多重耐药,美洛培南和亚胺培南是首选的经验性治疗鲍曼不动杆菌的药物,头孢哌酮/舒巴坦和米诺环素是治疗鲍曼不动杆菌最敏感的抗菌药物,对于多重耐药鲍曼不动杆(MDR-AB)感染,可采用头孢哌酮/舒巴坦和米诺环素联合治疗方案。

OBJECTIVE To study the distribution and the drug resistance of Acinetobacter baumanii from inpatients of our hospital,providing laboratory evidences for clinical treatment.METHODS Acinetobacter baumannii was identified by VITEK 2 Compact（bioMérieux Corporate） and susceptibility was determined by Kirby-Bauer method.The resistance rates were analyzed by WHONET 5.4 software.RESULTS The isolating rate of Acinetobacter baumanii was 6.62%,of which,81.16% were noted in sputum specimen.Acinetobacter baumanii infection mainly in rehabilitation department,neurology and ICU the most,followed by respiratory medicine.Acinetobacter baumanii were highly sensitive to cefoperazone/sulbactam and minocycline,with susceptible rates of both exceeding 80%,and which were also sensitive to imipenem and meropenem,with susceptible rates exceeding 60%,the other drugs with antibiotic resistance rate exceeding 50%.CONCLUSION Acinetobacter baumanii are the predominant opportunistic pathogenic bacteria in nosocomial infection,which are highly resistant and multiresistant to antibiotics.Meropenem and imipenem are the preferred empirical antibacterial therapy for Acinetobacter baumannii,cefoperazone/sulbactam and minocycline are the most susceptible antibacterial drug for Acinetobacter baumanii,infection with Multi-Drug Resistant Acinetobacter baumannii（MDR-AB）,using cefoperazone/sulbactam and minocycline treatment combinations.