儿童携带多重耐药及泛耐药鲍曼不动杆菌的耐药性分析

Drug resistance analysis on multiple drug resistant and pan-resistant Acinetobacter baumannii carried by children

目的：通过对该院儿科和河北省儿童医院临床分离的142株鲍曼不动杆菌的耐药性进行分析,为治疗儿童携带多重耐药及泛耐药鲍曼不动杆菌临床合理使用抗生素、提高抗生素使用效率、减少多重耐药鲍曼不动杆菌的发生、提高治疗效果提供理论依据。方法：采用K-B纸片扩散法对19种抗生素的耐药性进行试验,采用游标卡尺测量完全抑制区的直径包括纸片的直径。抑菌环大小判读参照M100,并报告测试的细菌对药物的耐药情况。结果：142株鲍曼不动杆菌中多重耐药菌72株,泛耐药菌24株,非多重耐药菌46株。多重耐药和泛耐药鲍曼不动杆菌对头孢类、碳氢酶烯类、氨基糖甙类、青霉素类、喹诺酮类、四环素类及磺胺类药物的耐药率均达到41.00%~99.00%,多粘菌素类药物的耐药率为0。结论：儿科病房分离的142株鲍曼不动杆菌对19种抗生素的耐药性逐渐提高,通过耐药性分析建议临床联合用药可以提高临床疗效。

Objective： To analyze drug resistance of 142 Acinetobacter baumannii strains clinically separated in pediatric department of this hospital and Hebei Children＇s Hospital, provide a theoretical basis for clinically reasonable application of antibiotics in treatment of multiple drug resistant and pan - resistant Acinetobacter baumannii carried by children, improving use efficiency of antibiotics, reducing the incidence rate of multiple drug resistant Acinetobacter baumannii infection and improving the curative effect. Methods： K - B paper disk diffusion method was used to conduct drug resistance test of 19 kinds of antibiotics, the diameters of complete inhibition zone and paper were measured by vernier caliper. Inhibition ring test was performed, and the results were interpreted according to M100, drug resistance rates of the tesled bacteria were reported. Results： Among 142 Acinetobacter baumannii strains, 72 multiple drug resistant Acinetobacter baumannii strains, 24 pan - resistant Acinetobacter baumannii strains and 46 non - multiple drug resistant Aeinetobacter baumannii strains were includ- ed. Drug resistance rates of multiple drug resistant Acinetobacter baumannii and pan - resistant Acinetobacter baumannii to cephalosporins, hydrocarbon enzyme alkenes medicine, aminoglycosides, penicillins, quinolones, tetracyclines and sulfonamides were 41.00% -99. 00% , while the drug resistance rate to polymyxins was 0. Conclusion： Drug resistances of 142 Acinetobacter baumannii strains separated from pe- diatric wards to 19 kinds of antibiotics increase gradually, the drug resistance analysis suggests that combination drug therapy can improve clinical efficacy.