2012-2014年2217株鲍曼不动杆菌感染分布及耐药性监测

Clinical distribution and drug resistance of 2,217 strains of Acinetobacter baumannii during 2012-2014

目的监测与分析医院近三年鲍曼不动杆菌分布及对常用抗菌药物的耐药性。方法对2012-2014年门诊及住院部各科室送检标本进行分离培养,用VITEK2-Compact全自动细菌分析仪进行细菌的鉴定及药敏分析,应用SPSS 13.0软件进行数据统计分析。结果近三年鲍曼不动杆菌共分离出2 217株,主要来源于痰液标本,占65.27%;且主要分布于重症医学科,其次是NICU及呼吸内科。2012-2014年鲍曼不动杆菌的分离率差异有统计学意义(χ2=266.1,P<0.005),以2014年最低,但鲍曼不动杆菌对抗菌药物的耐药性呈逐年上升趋势,特别是对亚胺培南的耐药情况严重,2014年耐药率高达84.8%,除对左氧氟沙星的耐药率较低(48.0%)外,对其他抗菌药物的耐药率均>50.0%。结论近三年来医院鲍曼不动杆菌的检出率高,对多种药物耐药率高,多重耐药严重,医院应加强对鲍曼不动杆菌感染性疾病特别是呼吸道感染的预防与控制及抗生素使用的管理,指导抗生素的合理使用,以降低医院感染率和病死率。

Objective To monitor and analyze the distribution and antimicrobial resistance of Acinetobacter baumannii in the First Affiliated Hospital of Nanchang University.Methods The submitted clinical specimens by in-and out-patient departments during 2012 and 2014were cultured.Bacteria and their antimicrobial susceptibility were identified by VITEK2-Compact automatic microbial analyzer.The statistical analysis was performed by SPSS 13.0.Results A total of 2,217 strains of A.baumannii were isolated,65.27% of which were isolated from sputum mainly from ICU department,NICU and department of respiratory medicine.There were statistically significant differences in the isolation rates of A.baumannii from 2012 to 2014（χ2=266.1,P〈0.005）.The lowest isolation rate was that in the year of 2014.The resistance rate showed an increasing trend in the 3years.The drug resistance to Imipenem was especially serious,which was up to 84.8%in 2014.The resistance rates to all the antibacterials were over 50.0%except to Levofloxacin（48.0%）.Conclusion The isolation rate of A.baumannii is high in recent 3years.These strains are highly resistant to multiple antibacterials.Prevention and control of A.baumannii infection,especially respiratory tract infection should be strengthened and the use of antimicrobial drugs be well monitored in order to decrease the morbidity and fatality rates in hospital.