湖南省某县2009-2012年鲍曼不动杆菌感染分布特征及耐药性变迁

Bacterial Distribution Features and Changes of Antibiotic Resistance of Acinetobacter baumanniiin Isolated in a County of Hunan Province During the Period of 2009-2012

目的了解医院感染鲍曼不动杆菌(ABA)临床分布特点及耐药性变化的趋势,为临床治疗鲍曼不动杆菌感染提供依据。方法回顾性调查分析2009年1月-2012年9月慈利县人民医院临床标本中分离的370株鲍曼不动杆菌的临床资料及15种抗生素的药物敏感性实验检测结果。结果 2009年1月-2012年9月共检出370株ABA,其中2009-2012年分别检出73、84、116、97株,检出率分别为9.2%、10.3%、12.5%、14.6%;主要分离于呼吸道标本(80.9%),临床分布以ICU病房、呼吸科和神经外科为主(61.2%);鲍曼不动杆菌对头孢哌酮/舒巴坦、米诺环素耐药率低于10%,对头孢吡肟、美罗培南的耐药率低于50%,对其余11种抗生素耐药率均高于50%,且呈逐年升高趋势。370株ABA有18株为全耐药菌株。结论鲍曼不动杆菌检出率逐年增加,对15种常用抗生素有不同程度的耐药,且耐药性逐年增加,应加强医院的耐药性监测,合理使用抗菌药物,以减少耐药株的产生。

Objective To investigate the bacterial distribution features and the changes of drug resistance ofAcinetobacter baumanniiin nosocomial infections,and to provide a basis for clinical treatment of the infections.Methods We collected the data about 370 strains ofA.baumanniiin isolated from clinical samples of the People＇s Hospital of Cili County from January 2009 to September 2012 and retrospectively analyzed the changes in their distribution and drug resistance to 15 kinds of antibiotics.Results Totally 370 strains ofA.baumanniiin were isolated from the clinical samples during the period,of which 73,84,116 and 97 strains were respectively isolated from 2009 to 2012,with the detection rates of 9.2%,10.3%,12.5%,and 14.6%,respectively.80.9% of the strains were isolated from respiratory tract samples.61.2% of the strains were isolated from ICU,department of respiratory diseases,and department of neurosurgery.The drug resistant rates ofA.baumanniiin to cefoperazone/sulbactam and minocyclin,to cefepime and meropenem,and to other 11 kinds of antibiotics were 10%,50%,and 50%,respectively;moreover,they showed a gradually increasing trend.Among 370 strains of A.baumanniiin,18 were pan-drug-resistant strains.Conclusions The detection rate and drug resistance ofA.baumanniiin were increased year by year.Nosocomial surveillance of drug resistance ofA.baumanniiin should be strengthened so as to use antibiotics rationally and minimize the development of antibiotic resistant strains.