重症监护室鲍曼不动杆菌感染的耐药变迁

Antimicrobial resistance changes of Acinetobacter Baumannii infection in intensive care units

目的了解重症监护室(ICU)鲍曼不动杆菌(ABA)感染的临床分布及其耐药变迁,为临床ICU治疗及预防鲍曼不动杆菌感染提供依据。方法回顾分析本院2008年-2011年ICU所分离出的鲍曼不动杆菌的耐药率及变化趋势。结果 2008年-2011年ICU鲍曼不动杆菌分离率有逐年增多趋势,该菌大多来自痰及咽拭子标本。该菌2008年-2011年耐药率总体呈上升趋势,耐药率上升最明显的是头孢曲松,从60.51%上升到98.72%,至2011年除阿米卡星,米诺环素和头孢哌酮(舒巴坦)3种抗菌药物外,耐药率均大于50%。结论 ICU内鲍曼不动杆菌耐药现象呈明显上升趋势,多重耐药鲍曼不动杆菌逐年增多,应重视多重耐药菌的预防隔离工作,防止交叉感染的发生,参照药敏结果合理选择使用抗菌药物。

Objective To understand the clinical distribution and antimicrobial resistance changes of Acinetobacter baumannii in intensive care unit （ICU）, and provide the basis for clinical therapy and prevention of Acinetobacter baumannii infection in ICU. Methods The data of Acinetobacter baumannii infection in ICU were retrospectively analyzed from 2008 to 2011, with regard to the antimicrobial resistance rate and the change tendency. Results From 2008 to 2011, the isolating rate of Acinetobacter baumannii increased in ICU year by year, and most were from sputums and gullet swabs. The drug resistance rate of Acinetobacter baumannii also showed overall upward trend, especially the drug resistance rate to ceftriaxone, increasing from 60.51% to 98.72%. Until 2011, the antimicrobial resistant rates of Acinetobacter baumannii were more than 50% except amikaein, minocycline and cefoperazone/sulbactam. Conclusion The antimicrobial resistance rates of Acinetobacter baumannii were in a rising/,rend, especially the multidrug resistant strains increased year by year in ICU. More attention should be paid to the prevention and separation of multidrug resistant strains to prevent cross infections. In addition, antimicrobial drug should be used in accordance with the drug sensitivity test results.