327株鲍曼不动杆菌临床分离与耐药性分析

Analysis on Distribution and Drug Resistance of 327 Strains of Acinetobacter Baumannii

目的分析鲍曼不动杆菌的临床分布及其对15种常用抗菌药物的耐药情况,为临床合理用药提供依据。方法对航天中心医院2011年3月-2012年2月分离出的327株鲍曼不动杆菌进行菌株鉴定和体外药敏试验,采用WHONET 5.0软件统计菌株耐药率。结果 327株鲍曼不动杆菌的标本主要分布于痰液、尿液、脓液、伤口分泌物、咽拭子、腹水、阴道分泌物,其中以痰液检出率最高311株(95.11%),重症监护室139株(42.51%)。药敏试验结果显示鲍曼不动杆菌对头胞哌酮-舒巴坦、亚胺培南、哌拉西林-他唑巴坦的耐药率分别为17.03%、81.96%、82.52%。结论鲍曼不动杆菌耐药情况较为严重,应定期监测其分布和耐药情况。头孢哌酮-舒巴坦对鲍曼不动杆菌呈现较强的体外抗菌活性,对于鲍曼不动杆菌引起的难治性感染可以考虑选用头孢哌酮-舒巴坦治疗。

Objective To analyze the distribution of Acinetabacter banmannii from Aerospace central hospital and the drug resistance to 15 commonly used antibiotics in our hospital, so as to guide the rational use of antibiotics in clinic. Methods The 327 strains of Acinetobacter baumannii which were separated from March 2011 to February 2012 were identified and undertaken vitro susceptibility test,to add up the ratio of antibacterial resistance according to WHONET 5. Results The distribution of 327 strains comprised sputum, urine, pus, wound secretion, swallow swab, ascites, vaginal secretion, most of them from sputum 311 strains （95.11% ）. 139 strains （42.51% ） of them were distributed in advancing patient＇s ward;vitro susceptibility test show the resistant rates of Acinetobacter baumannii to sulbactam-cefoperazone, imipenem, piperacillin-tazobactam were 17.03%, 81.96%, 82.52%. Conclusion Resistance of Acinetobacter baumannii was obvious, and periodic surveillance should be done to learn the drug resistance and bacterial distribution. Sulbactam-cefoperazone still shows strong antibacterial activity on the Acinetobaeter banmannii in vitro. Sulbactam-cefoperazone should be chosen to treat the severe infections caused by Acinetobacter baumannii.