2011—2013年某院鲍曼不动杆菌临床分布与耐药性分析

Clinical distribution and antimicrobial resistance of Acinetobacter baumannii isolated between 2011 and 2013

目的了解2011—2013年某院鲍曼不动杆菌的临床分布与耐药性变化趋势,为指导临床合理使用抗菌药物提供依据。方法对该院2011年1月—2013年12月分离的鲍曼不动杆菌来源和药敏试验结果进行统计分析。结果 2011—2013年共分离细菌14 705株,其中鲍曼不动杆菌1 999株(13.59%),3年鲍曼不动杆菌分别占分离病原菌的12.74%、13.05%、14.85%,呈逐年上升趋势(χ2=9.458,P=0.002)。标本来源主要为痰(1 541株,77.09%),分离科室以呼吸内科、外科重症监护室(SICU)和急诊重症监护室(EICU)为主,分别占21.71%、16.26%和8.26%。鲍曼不动杆菌对各类抗菌药物的耐药率均逐年升高(均P<0.05);多重耐药和泛耐药鲍曼不动杆菌分离率亦呈逐年上升趋势(均P<0.001),差异有统计学意义。结论医院鲍曼不动杆菌的分离率及耐药率均逐年上升,多重耐药及泛耐药现象较明显,临床科室应引起重视。

Objective To investigate the clinical distribution and change in antimicrobial resistance of Acinetobact-er baumannii （A.baumannii）from a hospital between 2011 and 2013,so as to provide guidance for clinical treat-ment.Methods Sources and antimicrobial susceptibility testing results of A.baumannii from a hospital were ana-lyzed statistically.Results A total of 14 705 bacterial isolates were isolated in 2011 —2013,13.59%（n=1 999）of which were A.baumannii isolates,the percentage of A.baumannii in isolated pathogens in 3 years was 12.74%, 13.05%,and 14.85% respectively,which showed a rising trend （χ2 =9.458,P =0.002）.The main specimen was sputum （n = 1 541 ,77.09%）,bacteria were mainly isolated from patients in respiratory disease department （21 .71 %）,surgical intensive care unit （16.26%）,and emergency intensive care unit （8.26%）.Antimicrobial re-sistance rates of A.baumannii increased year by year（all P 〈0.05）;multidrug-resistant and extensively drug-resist-ant A.baumannii also increased year by year （all P 〈0.001）.Conclusion Isolation rate and antimicrobial resistance rate of A.baumannii strains increase year by year,multidrug-resistant and extensively drug-resistant A.baumannii strains are obvious,which should be paid more attention in clinical department.