多药耐药鲍氏不动杆菌的临床分布与耐药性分析

Clinical distribution and drug resistance of multidrug-resistant Acinetobacter baumannii

目的为了解近年来临床分离的鲍氏不动杆菌分布特征及耐药性,为临床经验性选择抗菌药物提供依据。方法对医院2010年1-12月93株多药耐药鲍氏不动杆菌进行分离鉴定和药敏试验。结果多药耐药鲍氏不动杆菌对头孢哌酮/舒巴坦的耐药率最低为15.2%、对阿米卡星、亚胺培南的耐药率分别为23.9%和35.6%;其他药物则有较高的耐药率。结论对于多药耐药鲍氏不动杆菌的治疗,可以经验性选择头孢哌酮/舒巴坦,由于阿米卡星耳毒性和肾毒性不良反应,使临床使用受到限制;亚胺培南的耐药率高于卫生部全国细菌耐药监测网报道,可能与疾病早期使用碳青霉烯类抗菌药物有关。

OBJECTIVE To understand the distribution characteristics and drug resistance of Acinetobacter baumannii isolated in the recent years so as to provide basis for empiricai selection of antimicrohial agents. METHODS From Jan to Dec in 2010, a total of 93 strains of multidrug-resistant A. baumannii were isolated from clinical samples, the identification and the drug susceptibility testing for the isolated strains were performed. RESULTS The drug resistance rate of multidrug-resistant A. baumannii to cefoperazone/sulbactam was the lowest （15.2%） the resistance rates to amikacin and meropenem were 23.9% and 35.6%, respectively; the resistance rates to other antibiotics were relatively high. CONCLUSION Cefoperazone/sulbactam can be empirically selected for the treatment of multidrug-resistant A. baumannii, but its application is restricted due to the ototoxicity and renal toxicity of amikacin; the resistance rate to imipenem is higher than that reported by Ministry of Health National Antimicrobial Resistance Investigation Net, which may be associated with the use of carbopenems at early stage of disease.