生物被膜阳性鲍曼不动杆菌分布及耐药性分析

The distribution and drug-resistance of biofilm-positive acinetobacter baumannii

目的分析生物被膜阳性的鲍曼不动杆菌在重庆市肿瘤医院各科室间的分布及耐药情况,为该医院临床感染预防与治疗提供依据。方法收集经全自动细菌鉴定仪确定的鲍曼不动杆菌184株,采用刚果红培养基筛选生物被膜阳性菌株,K-B纸片法测定菌株耐药性。结果生物被膜阳性株标本种类以痰液和伤口分泌物居多,主要分布于ICU,呼吸科和骨科。鲍曼不动杆菌对氨基糖苷类抗菌药物耐药率最高:阳性株85.2%,阴性株67.5%。对米诺环素和头孢类联合棒酸抗菌药物(CSL和SAM)较为敏感:阳性株33.3%和35.7%,阴性株30.2%和19.8%。结论生物被膜阳性鲍曼不动杆菌与阴性株相比耐药率更高(P<0.05),可首先米诺环素、CSL和SAM作为抗菌药物,还应加强生物被膜阳性鲍曼不动杆菌耐药性监测,降低院内感染的发生率。

Objective To analyse distribution and drug-resistance situation of biofilm-positive Acinetobacter baumannii in Chongqing tumor hospital in order to provide references for the treatment and prevention of clinical infection. Methods 184 strains Acinetobacter baumannii were collected and identified with automated microbial analyzer. The Congo red medium was used to isola- ted biofilm-positive strains. The drug-resistance were determined with K-B method. Results The highest detection rate of Acineto- bacter baumannii was found in sputum and wound secretion. Departments with high to low detection rate were respectively ICU, re- spiratory,and orthopaedic department. Aminoglycoside antibiotics had the supreme drug-resistance for Acinetobacter baumannii.. positive strain 85.2 %, negative strains 67.5 %. The bacteria was more sensitive to minocyline and cephalosporins plus bar acid anti- hiotics（CSL and SAM）than others：positive strain 33.30% and 35.7%,negative strains 30.2 % and 19.8%. Conclusion Biofilm- positive strains show stronger drug-resistance than negative ones（P〈0.05）. Minocyline, CSL and SAM can be used as the pre- ferred antibacterial drugs. The surveillance of Acinetobacter baumannii should he enhanced to reduce the incidence of nosocomial in- fection.