2010年至2013年我院鲍曼不动杆菌耐药趋势分析

Acinetobacter Baumannii Drug Resistance Trend in Our Hospital from 2010 to 2013

目的了解医院鲍曼不动杆菌感染的临床分布和耐药现状,为规范临床合理应用抗菌药物提供依据。方法对医院2010年至2013年临床各科室送检标本中分离的580株鲍曼不动杆菌药物敏感性试验结果进行统计和分析。结果 4年来,微生物送检标本共计88 715例,检出鲍曼不动杆菌580株,占致病菌总数的1.63%;检出鲍曼不动杆菌的标本83.10%来源于痰液;215株鲍曼不动杆菌来自重症监护病房(ICU),占所有感染病区的37.07%,其次是神经内科76株(13.10%);对抗菌药物敏感(S)、多重耐药(NDR)、广泛耐药(XDR)菌株、全耐药(PDR)的菌株分别占检出鲍曼不动杆菌总数的19.83%,8.45%,16.90%,54.83%;ICU全耐药菌株占全耐药菌株总数的47.16%;鲍曼不动杆菌对亚胺培南的敏感率最高。结论鲍曼不动杆菌的耐药现象非常严重,且耐药率呈逐年上升趋势,需加强鲍曼不动杆菌耐药监测和临床合理应用抗菌药物管理,重视医院环境、工作人员消毒,遏制鲍曼不动杆菌在医院内的传播和流行。

Objective To understand the clinical distribution and drug resistance situation of Acinetobacter baumannii（AB） infection so as to provide the basis for standardizing clinical rational use of antibacterial drugs. Methods The drug susceptibility test results in 580 strains of AB isolated from the specimens submitted by the clinical departments from 2010 to 2013 were performed the statistical analysis. Results 88 715 specimens for conducting microbiological inspection were submitted during these 4 years. 580 strains of AB were detected out,accounting for 1.63% of total pathogenic bacteria;83.10% of specimens with AB detection was originated from sputum; 215 strains of AB were origenated from ICU,accounting for 37.07% of all infection wards,secondly 76 strains（13.10% ） from the neurological department; strains with the sensitivity to antibacterial drugs（S）, multi-drug resistance（NDR）,extensively drug resistance （XDR） and pan-drug resistance（PDR） accounted for 19.83% ,8.45% ,16.90% and 54. 83% of the total detected AB respectively; PDR from ICU accounted for 47.16% of the total number of drug-resistant strains;AB had the highest susceptibility rate to imipenem. Conclusion The drug resistance phenomenon of AB is very serious,moreover its drug resistance rate exhibits the increasing rend year by year;the AB drug resistance monitoring and the management of clinical rational use of antimicrobial drugs should be strengthened; more attention should be paid to the hospital environment and staff disinfection for restrainting AB spread and prevalence in hospital.