肿瘤患者鲍氏不动杆菌感染的耐药变迁

Antimicrobial resistance change of Acinetobacter baumannii in patients with tumor

目的了解肿瘤患者鲍氏不动杆菌(ABA)感染的临床分布及其耐药变迁,为肿瘤患者临床治疗及预防鲍氏不动杆菌感染提供依据。方法回顾分析本院2010年-2013年各肿瘤病房所分离出的鲍氏不动杆菌的耐药率及变化趋势。结果 2010年-2013年肿瘤病房鲍氏不动杆菌分离率有逐年增多趋势,该菌广泛分布于各临床科室,以肿瘤ICU为主,大多来自于患者的痰及咽拭子标本。该菌2010年-2013年耐药率总体呈上升趋势,耐药率上升最明显的是氨苄西林/舒巴坦,从36.08%上升到79.53%,其次是头孢曲松和头孢唑肟。至2013年除头孢哌酮外,耐药率均>50%。结论肿瘤患者鲍氏不动杆菌耐药现象呈明显上升趋势,多重耐药现象逐年增多,应重视多重耐药菌的预防隔离工作,防止交叉感染的发生,参照药敏结果,合理选择使用抗菌药物。

Objective To understand the clinical distribution and antimicrobial resistance changes of Acinetobacter baumannii（ABA） in patients with tumor,and provide the basis for the clinical therapy and prevention of ABA infection in tumor patients.Methods The data of ABA infection in patients with tumor from 2010 to 2013 were retrospective analysis,and statistics the the clinical distribution,rates of antimicrobial resistance and the tendency of change. Results The isolation rate of ABA was increasing year by year from 2010 to 2013 in patients with tumor. ABA infection distributed in various clinical departments,and mainly distributed at tumor ICU,and which were mostly isolated from patients＇ sputums and gullet swabs. The drug resistance rate from 2010 to 2013 showed an increasing tendency. In particular,the resistant rate to ampicillin / sulbactam was increased from 36. 08% to 79. 53%,followed by ceftriaxone and ceftizoxime. the antimicrobial resistant rate in 2013 was higher than50% except for the resistance rates to cefoperazone. Conclusion The antimicrobial resistance rates of ABA keeps a significant upward tendency in patients with tumor. Multidrug resistance strains increase year by year. More attentions should be paid to the prophylaxis and isolation of multidrug resistant strain to prevent cross infections.