2006年～2012年不动杆菌在儿科感染性疾病中的检出率与耐药变迁

Acinetobacter Baumannii Detected in Pediatric Infectious Diseases and Drug Resistance from 2006 to 2012

目的回顾性分析不动杆菌2006年-2012年在儿科感染性疾病中的分离率与耐药变化趋势，了解多重耐药、泛耐药不动杆菌在儿科疾病的感染状况。方法选取2006年～2012年门诊及住院患儿送检标本细菌培养所分离的376株不动杆菌，分析其在儿科疾病中的检出、分布特点及耐药变迁。结果所分离的不动杆菌以鲍曼氏／醋酸钙不动杆菌复合体及鲍曼不动杆菌最多共329株，洛菲不动杆菌16株，溶血不动杆菌9株，其它不动杆菌22株；2006年～2008年呼吸内科为不动杆菌菌株主要检出病区，2009年～2011年ICU病区为不动杆菌菌株主要检出病区，其次为血液及外科病区。所检出的不动杆菌对所选药物的耐药率逐年增长明显，多重耐药、泛耐药不动杆菌的检出率也呈逐年递增的趋势，尤以2009年~2010年增长最为显著。结论不动杆菌在儿科临床感染性疾病的检出率呈逐年增长且增长较快，尤以重症监护及血液病区检出增多明显，多重耐药、泛耐药不动杆菌的检出应引起临床医护人员的广泛重视，感染后的耐药监测及感染控制也已迫在眉睫。

Objective The artical retrospectively researched on the changes and trends of the isolation rate and the drug resistance of Acinetobacter in pediatric infectious diseases, as well as the infection of pan-resistant Aeinetobacter in pediatric diseases. Methods To select the bacterial samples of the children which outpatient and inpatient in Beijing Children＇s Hospital between 2006 - 2012, seperated 376 cases of Acinetobacter through bacterial culture, then researchzed on the detection in pediatric disease and the change of drug resistance, especially analyzed on the detected rate, laboratory characteristics and resistance mechanisms of Pan-resistant Acinetobacter retrospectively. Results In 376 Acinetobacter strains isolated from the bacterial samples, Bowman/calcium acetate Acinetobacter were checked out up to 158 strains, Acinetobacter baurnannii strains were 171 strains,AcinetobacterLafite were 16 strains,Acinetobacterhaemolyticus were 9 strains,Acinetobacter were 22 strains. Between 2006-2008 ,Institute of Respiratory Medicine in Beijing Children＇s Hospital had been the main detected ward of the Acinetobacter strains. Between 2009-2011, ICU ward had been the main detected ward of the Acinetobacter strains, followed by the blood and the surgical ward, the other strains isolated from neurology, dermatology, cardiology wards, and so on. The drug resistance of detected Acinetobacter to the selected drugs increased obviosly year by year, the detected rate of the pan-resistant Acinetobacter was in an increasing trend,the most significant growth had apperared between 2009-2010. Conclusion The deteced rate of Acinetobacter in pediatric clinical infections desease was increasing year by year,and the growth was rapidly, particularly in the ICU and the blood ward. The detected rate of the Pan-resistant Acinetobacter had increased significantly between 2009 - 2010, which should have been concerned extensively by clinical staff. It should be imminently to monitor the drug resistance and control the infection in pediatric infectious diseases.