多种抗菌药物对医院感染鲍氏不动杆菌的耐药性差异分析

Multiple drug resistance of Acinetobacter baumannii causing nosocomial infections

目的探讨医院感染临床标本中鲍氏不动杆菌(ABA)的分布特征及耐药率,对预防控制突发细菌感染起着重要的作用。方法回顾性分析医院2010年11月-2011年10月从住院患者各类感染标本中分离出的ABA感染情况及其耐药性。结果 391株ABA的分布以痰标本为主,占72.9%,其次为血液,占27.0%,支气管肺泡灌洗液,占17.0%;分布以神经内科、综合ICU和呼吸内科为主,分别占32.2%、23.8%和13.0%;该菌对氨苄西林、哌拉西林、头孢吡肟、头孢噻肟、左氧氟沙星、磺胺甲噁唑/甲氧苄啶的耐药率均>71.0%,而且多药耐药率较高,对亚胺培南和美罗培南的耐药率仅为2.8%和3.3%。结论 ABA是医院感染的重要条件致病菌,其对抗菌药物耐药率高,应合理使用抗菌药物,注重检测和预防控制感染的发生。

OBJECTIVE To investigate the distribution characteristics and drug resistance of Acinetobacter bauman-nil isolated from clinical specimens so as to provide basis for the prevention and control of bacterial infections. METHODS A retrospective survey was conducted for the A. baumannii infection and the drug resistance of the strains isolated from various clinical specimens of the hospitalized patients from Nov 2010 and Oct 2011. RESULTS Of totally 391 strains of A. baumannii, 72. 9% were isolated from sputum, followed by the blood （27. 0%）, bronchoalveolar lavage fluid （17.0%）; the strains were mainly distributed in neurology department （32.2%）, general ICU（23.8%）and respiratory medicine department （13.0%）, the drug resistance rates of the this species to ampicillin, piperacillin, cefepime, cefotaxime, levofloxacin and sulfamethizole/trimethoprim were higher than 71.0%, and the multidrug-resistanee rate was relatively high, the drug resistance rates to imipenem and meropenem were only 2.8% and 3.3%. CONCLUSION A. baurnannii isolates are the predominant opportunistic pathogenic bacteria causing nosocomial infections, and the drug resistance rate is so high that it is necessary to rationally use antibiotics so as to prevent and control the incidence of nosocomial infections.