2003-2010年鲍氏不动杆菌耐药性分析

Drug resistance of Acinetobacter baumannii between 2003 and 2010

目的调查鲍氏不动杆菌医院感染的分布及耐药性的变化,为预防控制医院感染提供相关科学依据。方法回顾性分析医院2003-2010年分离的鲍氏不动杆菌标本来源及临床分布,以K-B纸片扩散法考察其耐药性。结果医院鲍氏不动杆菌分离率总体呈上升趋势,其来源以痰液为主,占75.8%,主要分布在ICU占19.3%、呼吸科占17.0%、脑外科占13.8%和肝胆科占11.3%,鲍氏不动杆菌对所试验抗菌药物具有较高耐药率,对碳青霉烯类抗菌药物亚胺培南、美罗培南的耐药率上升趋势明显,此外,对阿米卡星、妥布霉素的耐药性也有提高。结论2003-2010年医院分离鲍氏不动杆菌分离率和耐药率呈上升趋势,多药耐药比例有所增加,除了加强对鲍氏不动杆菌的临床监控,还需合理使用抗菌药物,加强医务人员的无菌意识。

OBJECTIVE To investigate the distribution and drug resistance of Acinetobacter baurnannii causing nosocomial infections so as to provide scientific basis for the prevention and control of nosocomial infections. METHODS The specimen sources and the clinical distribution of the A. baumannii isolated from 2003 to 2010 were retrospectively analyzed, the drug resistance was observed by Kirby-Bauer method. RESULTS The isolation rate of A. baumannii presented as an upward tendency, the sputum was the major specimens source, accounting for 75.8%, which mainly distributed in the ICU （ 19. 3 %）, respiratory department （ 17. 0 %）, cerebral surgery department （13.8%） and hepatology department （11. 3%）, A. baumannii was highly resistant to thetested antibiotics, the drug resistance rates to carbapenems such as imipenem and meropenem were increased significantly, in addition, the drug resistance rates to amikacin and tobramycin were elevated. CONCLUSION Both the isolation rate and the drug resistance rate of A. baumannii keep an upward tendency from 2003 to 2010, and the multidrug-resistant strains have been increased. In addition to strengthening the clinical monitoring of A. bau- mannii, it is necessary to reasonably use antibiotics and intensify the medical staffrs awareness of sterilization.