医院重点科室鲍氏不动杆菌的分布及耐药性监测

Distribution and drug resistance of Acinetobacter baumannii in key departments

目的通过监测医院重点科室住院患者鲍氏不动杆菌的分布及耐药特征,以指导临床专科合理应用抗菌药物。方法回顾性分析2011-2012年临床分离的282株鲍氏不动杆菌在重点科室的分布及耐药率。结果 282株鲍氏不动杆菌分离率最高的科室为ICU,其次为神经外科、呼吸科及血液科,分别占27.5%、22.7%、15.7%、3.0%,各重点科室的检出率连续两年监测均有上升趋势;ICU、神经外科及血液科检出的鲍氏不动杆菌对常用抗菌药物的耐药率均>60.0%,神经外科检出的鲍氏不动杆菌对大部分抗菌药物耐药率均>80.0%,并有逐年升高趋势;呼吸科鲍氏不动杆菌对抗菌药物的耐药率比其他科室相对偏低,对常用抗菌药物的耐药率均<50.0%;各重点科室耐药率较低仅有亚胺培南,2012年ICU、神经外科鲍氏不动杆菌对亚胺培南耐药率为35.3%和26.3%,明显高于2011年监测结果。结论 ICU、呼吸内科、神经外科、血液内科鲍氏不动杆菌的分布及耐药率各有其特点,应根据各科的耐药率监测结果合理用药。

OBJECTIVE To monitor the distribution of Acinetobacter baumannii strains isolated from the hospital‐ized patients in key departments and analyze the characteristics of drug resistance so as to guide the reasonable clin‐ical use of antibiotics .METHODS From 2011 to 2012 ,the distribution and drug resistance rates of 282 A .bauman‐nii isolates in the key departments were retrospectively analyzed .RESULTS Of the 282 A .baumannii isolates , 27 .5% were isolated from the ICU ,22 .7% from department of neurosurgery ,15 .7% from department of respira‐tory ,3 .0% from department of hematology ,the isolation rates showed an upward trend in the key department in the two consecutive years .The drug resistance rates of the A .baumannii strains isolated from the ICU ,depart‐ment of neurosurgery ,and department of hematology to the commonly used antibiotics were more than 60 .0% , the drug resistance rate of the A .baumannii strains isolated from the department of neurosurgery to most of the antibiotics was more than 80 .0% ,showing an upward trend ;the drug resistance rate of the A .baumannii strains isolated from respiratory department was lower than that of the strains isolated from other departments ,and the drug resistance rate to the commonly used antibiotics was less than 50 .0% ;the drug resistance rate of the strains isolated from the key departments to imipenem was low ;the drug resistance rates of the A .baumannii strains iso‐lated from the ICU and department of neurosurgery to imipenem were respectively 35 .3% and 26 .3% in 2012 , significantly higher than those in 2011 .CONCLUSION The A .baumannii strains isolated from the ICU ,depart‐ment of respiratory medicine ,department of neurosurgery ,and department of hematology vary in the distribution as well as in the drug resistance rate ,and it is necessary to reasonably use antibiotics based on the drug resistance rates in the key departments .