2009-2013年鲍氏不动杆菌临床分布与耐药性分析

Analysis of clinical distribution and drug resistance of Acinetobactoer baumannii during 2009-2013

目的调查鲍氏不动杆菌的临床分布及其对抗菌药物的耐药性,为临床合理用药提供依据。方法采用回顾性方法分析2009-2013年检出的1 336株鲍氏不动杆菌标本来源、感染科室分布及抗菌药物耐药性,采用Whonet5.4软件进行药敏统计分析,统计数据采用Excel软件进行处理。结果 2009-2013年分离出鲍氏不动杆菌分别为154、172、272、389、349株,标本主要来源于痰液1 139株,占85.3%;临床科室以神经外科最多284株占21.3%,其次为老年病科222株占16.6%;鲍氏不动杆菌对头孢曲松、左氧氟沙星、阿米卡星、美罗培南及亚胺培南的耐药率分别由2009年的82.6%、57.0%、50.6%、38.4%、31.4%上升至2013年的94.8%、68.2%、63.3%、66.5%、60.2%。结论鲍氏不动杆菌临床耐药严重,临床应连续开展耐药性监测,合理使用抗菌药物,有效控制医院感染,延缓细菌耐药的产生。

OBJECTIVE To investigate clinical distribution of Acinetobactoer baumannii and its drug resistance a‐gainst antibiotics ,so as to provide foundation for rational use of drugs in clinical practice .METHODS By means of retrospective survey ,the specimen sources where the 1 336 strains of A .baumannii were isolated from 2009 to 2013 were investigated ,then the distribution of infections in departments and the drug resistance were analyzed . Drug sensitivity was analyzed by Whonet 5 .4 and all data were dealt with Excel .RESULTS Totally 154（4 .07% ） of A .baumannii were isolated in 2009 ,172（4 .50% ） in 2010 ,272（5 .99% ） in 2011 ,389（6 .39% ） in 2012 ,349 （5 .39% ） in 2013 .A .baumannii were mainly from sputum samples （1139strains ,85 .3% ） ,and neurosurgery de‐partment （284 strains ,21 .3% ） ,followed by geriatric department （222 strains ,16 .6% ） .There were 82 .6% , 57 .0% ,50 .6% ,38 .4% and 31 .4% of A .baumannii were resistant to cefatriaxone ,levofloxacin ,amikacin , meropenem and imipenem in 2009 ,respectively ,and their resistance rates increased to 94 .8% ,68 .2% ,63 .3% , 66 .5% and 60 .2% in 2013 .CONCLUSION Drug resistance of A .baumannii in the hospital becomes serious .It is necessary to carry out clinical monitoring and the rational use of antibiotics so as to control nosocomial infections and delay bacterial resistance .