儿童患者鲍曼不动杆菌临床分布及耐药性分析

Clinical distribution and drug resistance of acinetobacter baumannii in children

目的了解儿童患者鲍曼不动杆菌的临床分布特征及耐药现状,为临床合理选用抗菌药物提供依据。方法收集本院2010年1月至12月临床分离的124株鲍曼不动杆菌,采用K-B法检测药物敏感性。结果 124株鲍曼不动杆菌中,79株来自痰标本(占63.71%),20株来自血液标本(占16.13%)。病区来源以ICU病房最高(40.32%),其次为呼吸内科(21.77%)。在检测的19种药物中,耐药率超过50%的达13种(68.42%),且71株鲍曼不动杆菌呈多重耐药,占57.26%。耐药率最高为哌拉西林(81.45%),耐药率最低为多黏菌素B(1.61%),其次为头孢哌酮-舒巴坦(15.32%)。结论临床分离鲍曼不动杆菌多来源于呼吸道标本,以ICU和呼吸内科为主,且多重耐药现象十分严重。临床应加强对鲍曼不动杆菌耐药性监测,合理选用抗菌药物。

Objective To investigate the clinical distribution and drug resistance of acinetobacter baumannii in children. Methods The K-B method was used to detect the drug sensitivity of 124 acinetobacter baumannii isolated from Jan to Dec in 2010. Results Among the 124 strains of acinetobacter baumannii, 79 （63.71%） were isolated from sputum and 20 （16.13%） from blood. Strains isolated from the Intensive Care Unit accounted for 40.32%, followed by those from the Respiratory Department （21.77%）. Among the 19 antibiotics tested, 13 （68.42%） had resistance rate higher than 50.0 G, and 71 （57.26 %） were multi-resistant stains. Resistant rate to piperacillin （81.45%） was the highest. Resistance rate to polymyxin B （1.61%） was the lowest, followed by cefoperazone-sulbactam （15.32 %）. Conclusion Most clinically isolated acinetobacter baumannii are from respiratory specimens. Strains are mainly isolated from the Intensive Care Unitl Neurosurgery Department and Respiratory Department, with serious multi-resistance. Monitor of drug resistance of acinetobacter baumannii should be strengthened, and antimicrobial drugs should be used more ra- tionally.