某院近3年鲍曼不动杆菌耐药性变迁

Changes of drug resistance of Acinetobacter baumannii isolated from our hospital in recent three years

目的分析垫江县人民医院2010～2012年鲍曼不动杆菌的耐药性变迁，为临床合理用药并有效控制鲍曼不动杆菌感染提供依据。方法针对该院2010～2012年临床分离的鲍曼不动杆菌耐药情况及患者的感染情况进行回顾性统计分析。结果鲍曼不动杆菌的临床分离率从2010年的218例（12．19％）增高到2012年的741例（18．48％）。18种抗茵药物耐药率基本都在70％以上，重症监护病房、神经科等科室出现泛耐药菌株。抗茵药物的选择性压力是细菌发生耐药性变迁的主要动因之一，年龄、基础疾病、住院时间及侵入性操作等是患者感染的高危因素。结论医院应加强医疗环境、医疗器械及医护人员的消毒，加强医院感染监测，合理使用抗菌药物等一系列措施，可有效控制鲍曼不动杆菌的感染。

Objective To analyze the changes of drug resistance of Acinetobacter baumannii in our hospital during 2010--2012 to provide reference for clinical rational drug use and the effective control of Acinetobacter baumannii infection. Methods The drug resistance of Acinetobacter baumannii clinically isolated from 2010 to 2012 and its infection situation were retrospectively performed the statistical analysis. Results The clinical isolation rate of Acinetobacter baumannii in our hospital was increased from 218 cases （12.19%） to 741 cases （18.48%） in 2012. The resistance rates of 18 kinds of antibiotics were almost more than 70%, and pan- drug-resistant Aeinetobaeter baumannii appeared in some clinical departments, such as ICU and neurology. The selective pressure of antibiotic was one of the main motive causes of drug resistance change, and age, underlying diseases, duration of hospitalization and invasive procedures were the high risk factors in patients infection. Conclusion Hospital should enhance a series of measures including reinforcing the disinfection of the medical environment, medical equipments and medical staffs, strengthening the monito- ring of hospital infection and using antibiotics rationally to reduce and control the prevalence of Acinetobacter baumannii.