2890株鲍曼不动杆菌的分布特征及耐药谱变迁

Distribution and drug resistance of 2890 strains of Acinetobacter baumannii

目的探讨鲍曼不动杆菌的分布特征及耐药性的变迁,为临床治疗提供参考。方法回顾性分析2002年至2011年湖州市中心医院各类临床标本分离出的鲍曼不动杆菌检出率、分布特点及药敏结果。结果 10年共检出鲍曼不动杆菌2 890株,分离率为4.9%。来源以痰液为主,占84.3%。科室分布以重症监护室、呼吸内科、脑外科为主。鲍曼不动杆菌对替卡西林、替卡西林/棒酸、哌拉西林和氨苄西林/舒巴坦的耐药率最为严重,并逐年上升;对头孢他啶等10种抗菌药物耐药率也逐年上升,但对头孢哌酮/舒巴坦和多粘菌素E敏感性均良好。结论鲍曼不动杆菌的分离率和耐药性均呈上升趋势,应重视对该菌耐药性的监测,合理使用抗菌药物,同时加强院感控制,防止耐药菌株播散。

Objective To investigate the characteristic of distribution and the change in drug resistance of Acinetobacter baumannii,provide reference for clinical treatment.Methods The distribution and drug resistance of Acinetobacter baumannii isolated from various clinical specimens of the infectious patients in Huzhou Central Hospital from 2002 to 2011 were retrospectively analyzed and studied.Results A total of 2 890 strains of Acinetobacter baumannii were isolated during investigate period and the isolation rate was 4.9%.Sputum was the main specimen from which 84.3% strains of Acinetobacter baumannii were isolated.Acinetobacter baumannii were mainly distributed at ICU wards,pneumology department and neurosurgery department.The resistance rates to ticarcillin,ticarcillin/clavulanic acid,piperacillin and ampicillin/sulbactam were very high and appeared an increasing trend during investigate period.The resistance rates to other ten antibiotics were also increasing year by year.But to cefoperazone/sulbactam and polymyxin during investigate period,they were all sensitive.Conclusion The isolation rate and drug resistance of Acinetobacter baumannii are increasing,it is necessary for hospital to attach importance to the monitoring of its drug resistance,choose the antibiotics rationally and strengthen control the hospital infection,so as to prevent the spread of its multidrug-resistant strains.