3 266株鲍曼不动杆菌临床分布与耐药性分析

Distribution of A.baumannii infections and drug resistance in Ningbo

目的 了解近五年宁波市医疗中心李惠利医院分离的鲍曼不动杆菌（ABA）的临床分布和耐药性变化,为临床合理用药提供参考.方法 采用VITEK-32全自动微生物分析系统,对2009-2013年分离的鲍曼不动杆菌进行菌株鉴定和药敏试验,用WHONET5.4软件进行耐药性统计分析.结果 五年间该院共检出3 266株鲍曼不动杆菌,主要分离自痰液,占77.3％;临床分布主要来自ICU、呼吸内科、神经外科,分别占42.3％、19.6％、9.5％;鲍曼不动杆菌对临床常用抗菌药物的耐药率总体呈上升趋势,其中氨苄西林/舒巴坦、庆大霉素、氨曲南、妥布霉素、头孢吡肟上升幅度相对较小,其他抗菌药物上升幅度较大,除头孢哌酮/舒巴坦、亚胺培南外,对其他抗菌药物的耐药率均＞70％.结论 鲍曼不动杆菌耐药问题十分严重,应加强合理使用抗菌药物管理,定期监测,重点监测ICU等科室,防止发生严重的医院感染.

Objective To investigate the distribution and antibiotic resistance of A.baumannii during the last five years in our hospital,the basis for the reasonable clinical use of antibiotic was provided to doctor.Methods The strains of A.baumannii isolated from clinical specimens during 2009-2013 were analyzed by VITEK-32 system,the antibiotic resistance was analyzed by WHONET5.4 software.Results A.baumannii strains were mainly isolated from sputum,accounting for 77.3%;the majority of the strains were isolated from ICU,accounting for 42.3%;the resistance rates of A.baumannii to antibiotics appeared increasing,and over 70% except cefoperazone-sulbactam and imipenem.Conclusion A.baumannii is the major pathogen,and detection rate of A.baumannii is very high,antibiotic resistance status of A.baumannii is very serious.The management of antibiotic application should be strengthened,and the occurrence and prevalence of antibiotic resistant bacteria should be strictly controlled to prevent outbreak and epidemic of nosocomial infection.