连续3年重症医学科鲍曼不动杆菌的分布和耐药性分析

Three Consecutive Years Clinical Distribution and Drug Resistance of Acinetobacter Baumannii in Intensive Care Unit

目的了解重症医学科鲍曼不动杆菌（ABA）临床分布及耐药性，为指导临床合理用药，预防和控制感染提供依据。方法对某医院2008—2010年重症医学科患者的各类送检标本常规进行病原菌培养与鉴定。药敏试验采用K—B纸片法，使用WHONET5．4软件进行耐药性分析。结果ABA的检出率逐年增加，共分离出317株；主要来源于痰液，占ABA总数82．33％。多药耐药菌株（MDRO）检出率为83．91％；ABA对碳青霉烯类的耐药率日渐增高，其中对亚胺培南耐药率由2008年13．95％增加到2010年的75．65％；对其他抗菌药物耐药率均明显上升。结论重症医学科ABA检出率逐年增高，耐药严重，应加强对其耐药性监测与干预；临床应合理使用抗菌药物、加强手卫生、消毒灭菌及隔离工作对控制ABA感染非常重要。

Objective To investigate bacterial distribution and antibiotic resistance of Acinetobacter baumannii （ABA） nosocomial infection in intensive care unit to provide evidence for guiding clinical practice, preventing and controlling infection. Methods All kinds of specimens sent by out - and in - hospital patients from 2008 to 2010 were collected and the drug sensitive test was determined by Kirby - Bauer method, and the drug resistance was analyzed by using WHONET 5.4 software. Results From 2008 to 2010, the detection rate of ABA was increasing year by year, a total of 317 strains of ABA were isolated which accounted for 82.33%. Multiple drug - resistant strains were mainly come from sputum accounted for 83.91%. The rate of antibiotic resistance of ABA to carbapenems was increasing gradually. The drug resistance rate of ABA to imipenem was increased from 13.95% to 75.65% and the antibiotic resistance to other antimicrobial was increasing apparently. Conclusion The detection rate of ABA in ICU was increasing year by year and it showed a high rate of drug resistance, on which should be paid more attention and supervision. Many measures should be taken to control ABA infection, including using antibiotics rationally, hand hygiene, disinfect and isolate infectious position.