亚胺培南耐药鲍曼不动杆菌的临床分布和药敏分析

The infection characteristics and antimicrobial-resistant profile of imipenem-resistant acinetobacter baumannii

目的了解该院鲍曼不动杆菌的临床分布及耐药性特征,为临床合理使用抗菌药物、降低院内感染率提供参考依据。方法按常规方法进行细菌培养,采用VITEK2Compact全自动微生物分析仪对临床分离病原菌进行鉴定和药敏试验,使用WHONET5.5软件进行数据统计分析。结果该院2009年8月至2011年9月共分离到鲍曼不动杆菌471株,85.4%(398株)的菌株分离自下呼吸道样本;重症监护室(ICU)和神经外科分别分离到222株(47.1%)、72株(15.3%),分离自ICU和神经外科的鲍曼不动杆菌对19种抗菌药物的耐药率高于其他科室分离株(P<0.01);267株(56.7%)鲍曼不动杆菌对亚胺培南耐药,除头孢唑啉和呋喃妥因外,亚胺培南耐药株对阿米卡星等18种抗菌药物耐药率均高于敏感率,二者差异具有统计学意义(P<0.05)。结论 ICU和神经外科重症患者是鲍曼不动杆菌的易感人群,亚胺培南耐药鲍曼不动杆菌多重耐药情况严重,实验室应加强鲍曼不动杆菌耐药性监测,规范临床用药,隔离泛耐药鲍曼不动杆菌感染者,防止医源性传播。

Objective To investigate the clinical distribution and drug resistant characteristics of A.baumannii for the clinical rational use of antibiotics as well as reducing infection.Methods Isolated bacteria were cultured by routine methods,also identified and performed drug susceptibility test by automatic bacteria analysis system VITEK 2 compact.Statistical analysis of A.baumannii was conducted by WHONET5.5 software.Results 471 stains of A.baumannii were isolated from August 2009 to September 2011 in this hospital.398（85.4%） strains were from lower respiratory tract samples.222（47.1%） strains and 72（15.3%） strains were from ICU and neurosurgery.A.baumannii isolated from ICU and neurosurgery showed significantly higher resistance to 19 kinds of antibiotics than others（P0.01）.267（56.7%） strains of A.baumannii were resistant to imipenem.In addition to cefazolin and nitrofurantoin,the resistance rates of imipenem-resistant strains to amikacin and other 18 kinds of antimicrobial drug were significantly higher than the sensitive strains（P0.05）.Conclusion ICU and neurosurgical patients are susceptible to A.baumannii.The resistance of imipenem-resistant A.baumannii is serious.It is essential to strengthen monitoring the resistance of A.baumannii,as well as making reasonable use of antibiotics and separating patients to control A.baumannii infection.