鲍氏不动杆菌的临床分布特征及耐药性监测

Clinical characteristics of distribution of Acinetobacter baumannii and monitoring of drug resistance

目的了解鲍氏不动杆菌感染的临床分布和耐药现状,为医院感染的控制和指导临床合理用药提供帮助。方法收集医院2008-2011年从临床送检标本中分离的499株鲍氏不动杆菌,常规方法结合ATB Expression微生物分析仪鉴定细菌,药敏试验采用CLSI/NCCLS推荐的K-B纸片扩散法。结果 2008-2011年鲍氏不动杆菌的检出率分别为8.04%、9.65%、11.97%和14.46%,呈现逐年上升的趋势;临床标本来源以呼吸道标本为主占74.2%;临床科室分布以ICU为主,占61.3%,且ICU的检出率呈现出逐年上升的趋势;药敏结果显示鲍氏不动杆菌对常用抗菌药物的耐药率呈逐年上升趋势,并显示出多药耐药性,其中多黏菌素B、米诺环素和头孢哌酮/舒巴坦的耐药率相对较低,分别为1.4%、34.5%和37.5%。结论鲍氏不动杆菌已成为医院感染重要病原菌,对多种抗菌药物耐药,临床应加强耐药性监测,合理使用抗菌药物,有利于预防及控制医院感染的暴发流行。

OBJECTIVE To investigate the clinical features of distribution of Acinetobacter baumannii infections andthe current status of drug resistance so as to control the nosocomial infections and guide the reasonable use of anti-biotics. METHODS A total of 499 strains of A. baumannii isolated from the clinical submitted specimens from 2008to 2011 were collected, then the conventional method combined with ATB Expression microbic system was employed to identify the bacteria, and the drug susceptibility testing was performed by using K-B disk diffusion method recommended by CLSI/NCCLS. RESULTS The detection rates of the A. baumannii strains were respectively8.04%, 9.65%, 11.97%, and 14. 46% from 2008 to 2011, showing an upward trend. Among the clinical speci-mens sources, the respiratory tract specimens were dominant, accounting for 74. 2% ; the ICU was the predomi-nant clinical department, accounting for 61. 3%,with the detection rate showing an upward trend. The drug susceptibility testing showed that the drug resistance rates of the A. baumannii strains to the commonly used antibiotics kept an upward tendency, and the strains were multidrug-resistant,the drug resistance rates to polymyxin B,minocycline, and cefoperazoae-sulbactam were relatively low, which were 1. 4% , 34.5%,and 37. 5%,respec-tively. CONCLUSION The A. baumannii strains have become the major species of pathogen causing nosocomial in-fections and are multidrug-resistant. It is necessary for the hospital to strengthen the monitoring of drug resistanceand reasonably use antibiotics so as to prevent and control the nosocomial infections.