2009-2012年医院鲍氏不动杆菌分布及耐药性变迁

Changes in distribution and drug resistance of Acinetobacter baumannii in hospital in 2009-2012

目的了解医院鲍氏不动杆菌分布及耐药性变迁,为临床合理用药提供参考依据。方法回顾性分析2009-2012年医院临床送检各类标本7 415份分离出的鲍氏不动杆菌分布及药敏结果,数据采用SPSS17.0软件统计分析。结果共分离出鲍氏不动杆菌752株,分离率10.14%;标本来源以痰液为主,占77.40%;科室分布以ICU为最多,占48.54%;鲍氏不动杆菌对抗菌药物保持较高耐药水平,总体呈逐年上升趋势;尤其是对碳青酶烯类抗菌药物亚胺培南、美罗培南的耐药率呈较高水平;鲍氏不动杆菌对15种抗菌药物的耐药率均>60.00%。结论鲍氏不动杆菌的分离率和耐药率呈逐年上升趋势,分离率高,多药耐药和泛耐药性严重;该菌主要分布在ICU等高危病区;临床科室应加强抗菌药物管理,依据药敏结果合理应用抗菌药物,同时做好ICU、神经外科、呼吸内科等重点科室的感染控制,防止耐药菌播散。

OBJECTIVE To detect the changes in distribution features and drug resistance of Acinetobacter bauman‐nii （A .baumannii） causing nosocomial infections ,so as to offer a basis for clinical reasonable application of anti‐biotics .METHODS The clinical distribution and drug resistance of A .baumannii in 7 415 clinical specimens of va‐rious types collected from the year 2009 to 2012 were retrospectively analyzed .The analysis and drug sensitivity results of the isolated strains were analyzed with the statistical software SPSS 17 .0 .RESULTS There were 752 strains of A .baumannii isolated from 2009 to 2012 ,the isolation rate of A .baumannii strains was 10 .14% .The sputum was the major specimen source ,accounting for 77 .40% .The isolated bacteria were predominant in the intensive care unit （ICU） ,accounting for 48 .54% .A .baumannii was highly resistant to the 16 tested antibiotics , showing an increasing trend of resistance by years .The drug resistance rates to carbapenems such as Imipenem and meropenem were relatively high .The drug resistance rate of the A .baumannii to 15 antibioties was more than 60 .00% .CONCLUSION Both the isolation rate and the drug resistance rate of A .baumannii keep an upward tendency year by year ,and the multi and pan‐drug resistant strains have been increased ,which are mainly distrib‐uted in the high risk departments such as ICU .Thus it is necessary to enhance the management of antibiotics and the reasonable antibiotic usage according to sensitivity results ,intensify the control of nosocomial infections in key departments of ICU ,neurosurgery and respiratory medicine to prevent the outbreak and reduce the prevalence of nosocomial infections .