鲍曼不动杆菌的临床分布和耐药性分析

Analysis of clinical distribution and drug resistance of Acinetobacter baumannii

目的了解鲍曼不动杆菌菌株分布及对常用抗菌药物的耐药性,为临床抗感染治疗提供依据。方法采用法国生物梅里埃Vitek2-Compact对临床标本中分离出的细菌进行鉴定及药敏试验,分析2011年3月至2012年2月常规细菌培养分离的91株鲍曼不动杆菌的分布情况及其耐药性。结果检出的91株鲍曼不动杆菌中,以痰液分离率较高(79.1%),临床分布以呼吸内科(38.4%)和神经外科为主(15.4%)。鲍曼不动杆菌对15种常用抗菌药物的耐药率以阿米卡星最低(6.6%),其次为亚胺培南(16.4%),对其余抗菌药物的耐药率均较高。91株鲍曼不动杆菌中,有8株为泛耐药菌株。结论鲍曼不动杆菌对15种常用抗菌药物存在不同程度的耐药性,应加强鲍曼不动杆菌的耐药性监测,为临床合理选用抗菌药物提供依据。同时应对泛耐药鲍曼不动杆菌采取有效的预防措施,避免泛耐药菌株的暴发流行。

Objective To investigate the clinical distribution of Acinetobacter baumannii and understand antibiotic resistance,and provide the basis data for clinical anti-infective treatment.Methods We used VITEK2-compact to do the identification and drug resistance of isolated bacteria of clinical specimens.We collected 91 strains of Acinetobacter baumannii from March 2011 to February 2012,and analyzed their clinical distribution and drug resistance.Results A total of the 91 strains of Acinetobacter baumannii were isolated.79.1% were from sputum,and clinical distributions were mainly in respiratory medicine（38.4%） and neurosurgery（15.4%）.In the drug resistance rates of Acinetobacter baumannii to 15 frequently used antimicrobial,the lowest was to Amikacin（6.6%）,secondly to imipenem（16.4%）,and the remainders of the antimicrobial resistance rates were high.In 91 strains of Acinetobacter baumannii,8 strains were extensively drug resistant strains.Conclusion Acinetobacter baumannii to 15 frequently used antibiotics exists different degree of resistance.In order to provide the basic evidence for clinical use of antibiotics reasonably,we should strengthen monitoring the drug resistance of Acinetobacter baumannii.Meanwhile we should take effective measures to prevent the drug abuse of Acinetobacter baumannii.