687株不动杆菌属细菌临床分布及耐药分析

Analysis of Specimens Distribution and Drug Resistance of 687 Strains of Acinetobacter sp

目的了解不动杆菌在临床上的分布,预防和控制医院感染。方法对2010年1月～2011年12月临床各科送检的各种标本中分离出的不动杆菌进行临床分布及耐药性分析。结果鲍曼不动杆菌占不动杆菌属的77.3%,不动杆菌标本来源以呼吸道为主,占88.1%,其他依次为分泌物占5.8%、尿液占2%;不动杆菌对头孢西丁、氨曲南耐药率最高,耐药率分别为94.1%、93.3%,头孢菌素类抗菌药物如头孢呋辛、头孢曲松,氨基糖苷类抗菌药物如庆大霉素、复方新诺明和阿米卡星,喹诺酮类如环丙沙星、左氧氟沙星耐药率分别为86.5%、85.9%、72.4%、71.8%、54.1%、71.6%、40%。多粘菌素活性最高,敏感率达92.8%,其次为头孢哌酮舒巴坦,敏感率为78.3%。结论临床分离的不动杆菌中鲍曼杆菌分离率高,标本来源以呼吸道为主。应加强抗菌药物的合理应用督导,控制医院感染,保证医疗安全。

Objective To investigate the clinical specimens distribution of acinetobacter sp, so as to prevent and control the nosocomial infections. Methods The clinical distribution and drug resistance of acinetobacter sp isolated from various specimens obtained from January 2010 to December 2011 were analyzed. Results Of all the acinetobacter sp, A baumanii accounted for 77.3% , and mainly distributed in respiratory tract, accounting for 88.1%. Secretion and urine were next in order,accounting for 5.8% and 2% ,separately. Acinetobacter sp mostly resisted to cefoxitin and ammonia. The resistance rates were 94.1% , 93. 3%, respectively. The resistance rates to cephalosporin antibiotic drugs such as cefuroxime and ceftriaxone, aminoglycoside antibiotic drugs such as gentamicin, sulfamethoxazole/trimethoprim and amikacin, quinolones such as ciprofloxacin and levofloxacin were 86. 5% , 85. 9% , 72. 4% , 71. 8% , 54.1% , 71.6% , 40% respectively. But polymyxin remained the most potent, the sensitive rate reached 92.8%, followed by cefoperazone/sulbactam with 78. 3%. Conclusion The separate rate of A. baumanii is high among the clinical strains of acinetobacter sp. And the main specimens source comes from respiratory tract. The supervision of the reasonable application of antimicrobial drugs should be strengthened, nosocomial infections should be controlled to ensure medical safety.