某院重症监护病房鲍曼不动杆菌5年耐药变迁

Change of drug resistance during five years of acinetobacter baumannii in ICU of a hospital

目的了解襄阳市中医医院重症监护病房(ICU)鲍曼不动杆菌2006～2010年耐药变化状况,为临床医师合理用药提供依据。方法收集襄阳市中医医院2006～2010年ICU分离的343株鲍曼不动杆菌的耐药性进行回顾性分析。结果襄阳市中医医院ICU鲍曼不动杆菌2006～2007年耐药率比较稳定,2008～2010年呈逐年上升趋势。其中头孢他啶、头孢噻肟、头孢吡肟耐药率从2008年58.8%、64.7%、51.4%增加至2010年的69.7%、70.8%、66.3%。襄阳市中医医院2006～2010年鲍曼不动杆菌对亚胺培南、米诺环素、哌拉西林/舒巴坦耐药率相对较低。对头孢子菌素、环丙沙星、庆大霉素、复方新诺明耐药率相对较高(>50%)。结论 2006～2007年ICU病房鲍曼不动杆菌耐药率比较稳定;2008～2010年呈逐年上升趋势,而且多药耐药现象极为严重,应加强耐药性监测合理使用抗菌药物,防止或减慢耐药菌株的形成。

Objective To investigate the change of drug resistance during 2006--2010 of acinetobacter（ A. ） baumannii in ICU to provide the basis for rational drug use in clinic. Methods From 2006 to 2010,the drug resist- ance in 343 strains of A. baumannii identified from ICU were retrospective analyzed. Results The drug resistance rate was stable during 2006--2007 and were increased during 2008 --2010. The resistance rates to ceftazidime,cefo- taxime and cefapime were increased from 58.8%, 64.7% and 51.4% in 2008 to 69.7%, 70. 8% and 66.3% in 2010. A. baumannii in our hospital during 2006--2010 had the low reistance rates to imipenem, minocycline and cef- operazone/sulbaetam and the high resistance rates to cephalosporin, ciprofloxacin, gentamicin, sulphamethoxazole/ trimethoprim（〉50 %）. Conclusion The drug resistance of A. banmannii in our hospital was stable during 2006-- 2007 and showed increasing trend during 2008--2010. The multi-drug resistance phenomena were extremely serious. Monitoring drug resistance and rational drug use should be strengthened to prevent or slow down the formation of re sistant strains.