254株鲍氏不动杆菌的分布及耐药性

Distribution and drug resistance of 254 strains of Acinetobacter baumannii

目的了解医院痰标本分离出鲍氏不动杆菌的科室分布及药敏结果,为临床合理用药提供参考。方法收集医院2009年5月-2011年8月送检痰标本中分离出的254株鲍氏不动杆菌,并比较检出鲍氏不动杆菌科室的分布及药敏结果。结果 3455份痰标本共检出鲍氏不动杆菌254株,检出率为7.4%;鲍氏不动杆菌主要分布于ICU,占47.6%,其他依次为神经外科、呼吸内科、神经内科、肿瘤科,分别占18.1%、15.7%、11.8%、2.8%;鲍氏不动杆菌对15种常用抗菌药物中14种普遍耐药,平均耐药率高达79.6%,仅对头孢哌酮/舒巴坦表现出较敏感,敏感率为73.6%;ICU、神经外科、呼吸内科、神经内科的多药耐药、泛耐药菌株检出率显著高于其他科室(P<0.05)。结论痰标本中鲍氏不动杆菌耐药率较高,其中多药耐药株、泛耐药株占有很高的比例,临床应引起高度重视;一旦发现感染耐药株,必须迅速采取控制措施,控制医院感染的蔓延。

OBJECTIVE To investigate the distribution of Acinetobacter baumannii isolated from sputum specimens in clinical departments and the drug susceptibility testing.METHODS A total of 254 strains of A.baumannii isolated from sputum specimens submitted from May 2009 to Aug 2011 were collected,the distribution of A.baumannii in clinical departments and the result of drug susceptibility testing were analyzed.RESULTS Totally 254 strains of A.baumannii were isolated from 3455 sputum samples with the detection rate of 7.3%;A.baumannii isolates mostly distributed in ICU,accounting for 47.6%,followed by department of neurosurgery,department of respiratory medicine,department of neurology,and tumor department,accounting for 18.1%,15.7%,11.8%,and 2.8% respectively;A.baumannii was resistant to 14 of 15 kinds of commonly used antibiotics with the average resistance rate reaching up to 79.6% and was only susceptible to cefoperazone/sulbactam with the susceptibility rate of 73.6%;the detection rates of the multidrug-resistant strains and pandrug-resistant isolates from ICU,department of neurosurgery,department of respiratory medicine,and department of neurology were significantly higher than those from other departments（P0.05）.CONCLUSION The drug resistance rate of A.baumannii isolated from sputum is relatively high,multidrug-resistant strains and pan-resistant isolates occupy a large proportion,which should be attached great importance;once the resistant isolates are detected,the corresponding measures should be taken to control the spread of nosocomial infections.