2009-2011年ICU鲍氏不动杆菌的临床分布及耐药性变迁

Distribution of clinical isolates of Acinetobacter baumannii in ICU and change of drug resistance from 2009 to 2011

目的了解医院鲍氏不动杆菌的临床分布和耐药性的变迁,为临床感染的预防和治疗提供参考。方法对医院ICU2009-2011年临床分离的802株鲍氏不动杆菌临床分布及药敏结果进行回顾性分析。结果 2009-2011年共分离鲍氏不动杆菌802株,检出率为19.48%,呈逐年上升趋势;最常见分离自痰标本,占84.4%,其次是排泄物和分泌物,分别占4.1%、3.5%;鲍氏不动杆菌对常用抗菌药物均产生了不同程度的耐药性,对美罗培南和亚胺培南耐药率均逐年上升,2011年分别达到75.7%和76.0%,目前多黏菌素B对鲍氏不动杆菌最为敏感,耐药率<4.0%,且呈逐年下降趋势。结论鲍氏不动杆菌是ICU患者呼吸道感染的常见病原菌,且耐药性高,头孢哌酮/舒巴坦是治疗鲍氏不动杆菌较敏感的药物,鲍氏不动杆菌对碳青霉烯类抗菌药物严重耐药,应引起高度重视。

OBJECTIVE To investigate the clinical distribution of Acinetobacter baumannii and analyze the change of drug resistance so as to provide basis for the prevention and treatment of clinical infections. METHODS The clinical distribution of 802 strains of clinical isolates of A. baurnannii and the result of drug susceptibility testing were retrospectively analyzed. RESULTS Totally 802 strains of A. baumannii were isolated from 2009 to 2011 with the detection rate of 19.48% ,and the detection rate showed an upward trend. The sputum was the predominant specimen, accounting for 84.4%, followed by the excreta （4.1%） and secretions （3.5%）. The A. baumannii strains varied in the drug resistance to the commonly used antibiotics,the drug resistance rate to meropenem or imipenem increased year by year, respectively reaching to 75.7% and 76.0% in 2011, the strains were most sensitive to polymycin, the drug resistance rate was less than 4.0%, showing a downward trend. CONCLUSION The A. baumannii is a common species of pathogen causing respiratory tract infections in the ICU patients, and cefoperazone/ sulbactam is the sensitive antibiotics to treat the A. baumannii infections. The A. baumannii is so highly resistant to carbapenem antibiotics that great attention should be paid.