鲍氏不动杆菌医院感染分布特点及耐药性分析

Distribution and drug resistance of Acinetobacter baumannii causing nosocomial infections

目的了解医院感染的鲍氏不动杆菌分布及耐药性变化,为合理使用抗菌药物和医院感染的预防控制提供相关科学依据。方法回顾性分析医院2007-2012年分离的鲍氏不动杆菌标本来源及临床分布,以K-B纸片扩散法检验其耐药性,观察鲍氏不动杆菌耐药性的变化。结果医院感染鲍氏不动杆菌标本来源以痰液为主,占88.6%;主要分布在ICU占29.17%、儿科占16.41%、神经外科占13.38%和呼吸内科占12.15%;2010年前医院鲍氏不动杆菌分离率总体呈上升趋势,2010年出现明显回落,之后其分离率波动不明显;鲍氏不动杆菌对所试验抗菌药物具有较高耐药率,对哌拉西林、氨曲南耐药率上升趋势明显,2010年其对全部药物的耐药率>50.0%,2010年后鲍氏不动杆菌耐药上升趋势有所遏制。结论 ICU是医院感染鲍氏不动杆菌的主要科室之一,抗菌药物的规范应用结合医院感染预防控制措施的落实,有利于减少耐药菌株的产生,控制耐药菌株的传播及流行,从而有效遏止鲍氏不动杆菌多药耐药的发展。

OBJECTIVE To investigate the distribution and drug resistance of Acinetobacter baumannii causing nosocomial infections so as to provide scientific bases for the reasonable use of antibiotics and the control of nosocomial infections.METHODS From 2007 to 2012,the specimen sources where the A.baumannii strains were isolated and the clinical distribution were retrospectively analyzed,the drug susceptibility testing was performed by using K-B disk diffusion method,and the change of drug resistance of the A.baumannii strains was observed.RESULTS Among the isolated A.baumannii strains causing nosocomial infections,88.6% were isolated from the sputum specimens;29.17% of the strains distributed in the ICU,16.41%in the pediatric department,13.38%in neurosurgery department,12.15%in the respiratory medicine department.The isolation rate of the A.baumannii strains showed an overall upward trend before 2010,significantly declined in 2010,and then did not fluctuate remarkably after 2010.The A.baumannii strains were highly resistant to the tested antibiotics,the drug resistance rate to piperacillin and aztreonam showed a remarkable upward trend,the drug resistance rate to all the antibiotics was more than 50.0%in 2010,and the increasing trend of drug resistance of the A.baumannii strains was curbed to a certain extent.CONCLUSIONThe ICU is one of the key departments where the A.baumannii infection is prevalent.It is an effective way to conduct the reasonable use of antibiotics combined with implementation of prevention and control measures to reduce the drug-resistant strains and control the spread and prevalence of the drug-resistant strains so as to curb the development of multidrug-resistance of the A.baumannii strains.