某院重症医学科2010—2013年鲍曼不动杆菌耐药性监测

Monitoring of antimicrobial resistance of Acinetobacterbaumanniiin the intensive care unit of a hospital from 2010 to 2013

目的分析重症医学科2010—2013年鲍曼不动杆菌(AB)的检出率及耐药特征,为临床抗感染治疗提供依据。方法对某院重症医学科2010—2013年AB检出情况、耐药性进行回顾性分析。结果 2010—2013年共分离病原菌1 413株,其中AB共556株,占39.35%,每年AB检出率分别是39.45%、41.35%、29.44%、40.53%。AB主要来源于下呼吸道(占75.72%)。药敏试验结果显示耐药率较低的抗菌药物是头孢哌酮/舒巴坦(5.85%)和阿米卡星(17.45%);2010—2013年多重耐药、泛耐药AB检出率分别从9.63%、3.70%,上升至42.50%、31.88%,差异均有统计学意义(均P<0.001)。结论 AB是重症医学科最常见致病菌,对抗菌药物耐药严重,多重耐药、泛耐药AB检出率逐年增加;加强对AB的耐药性监测,有利于治疗和预防AB感染。

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii（AB）from intensive care unit（ICU）between 2010 and 2013,and provide evidence for clinical anti-infective therapy.Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retrospectively.Results A total of 1 413 pathogenic strains were isolated,556（39.35%）of which were AB,isolation rates in each year were 39.45%,41.35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract（75.72%）.Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam（5.85%）and amikacin（17.45%）;detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31.88%,respectively（both P〈0.001）.Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treatment and prevention of AB infection.