1007株鲍氏不动杆菌的临床分布及耐药性分析

Clinical distribution and drug resistance of 1007 strains of Acinetobacter baumannii

目的了解医院2008年1月-2010年12月分离的鲍氏不动杆菌(ABA)临床分布与耐药性变迁,为临床合理使用抗菌药物提供依据。方法对临床送检的各类标本进行细菌分离、鉴定、药敏试验及统计分析。结果 3年中共分离出ABA 1007株,占同期临床总分离菌的10.03%;主要分布科室为ICU 342株占34.25%,呼吸科222株占22.29%,神经科138株占13.78%;主要标本分布为痰液841株占83.52%,尿液90株占8.94%,分泌物46株占4.57%;其中多药耐药ABA占41.51%;ABA对亚胺培南、美罗培南、头孢哌酮/舒巴坦和阿米卡星的耐药率均<40.00%,而对其余抗菌药物的耐药率均>60.00%,对亚胺培南的耐药率从2008年的25.96%上升至2010年的39.27%。结论近3年医院临床分离的ABA耐药性呈逐年增高趋势,多药耐药及泛耐药的ABA所占比例极高,因此,加强耐药性检测和监测,对指导合理使用抗菌药物非常重要。

OBJECTIVE To investigate the distribution and the drug resistance rates of Acinetobacter baumannii strains isolated in the hospital from Jan 2008 to Dec 2010 so as to provide basis for the reasonable use of antibiotics.METHODS The isolation and identification of the bacteria isolated from the clinically submitted specimens were performed,the drug susceptibility testing and the statistical analysis were carried out.RESULTS A total of 1007 strains of A.baumannii were isolated during the three years,accounting for 10.03% of all the isolated bacteria.There were 342（34.25%） strains isolated from ICU,222（22.29%） strains from respiratory department,and 138（13.78%） stnains from the neurosurgery department.Totally 841（83.52%） strains were isolated from the sputum,90（8.94%） strains from the urine,and 46（4.57%） strains from the secretions.The multiclrug-resistant A.baunmannii accountecl for 41.51%.The drug resistance rates of A.baumannii strains to imipenem,meropenem,cefoperazone/sulbactam and amikacin were lower than 40.00%,the drug resistance rate to other antibiotics was higher than 60.00%,the drug resistance rate to imipenem increased from 25.96% in 2008 to 39.27% in 2010.CONCLUSION The drug resistance of the A.baumannii strains isolated in the recent three years increases year by year,and the multidrug-resistant A.baumannii and pandrug-resistant A.baumannii take a large proportion,thus,it is necessary to strengthen the detection and monitoring of drug resistance,which is very important for the guidance of reasonable use of antibiotics.