某院2014年鲍曼不动杆菌感染的临床分布及耐药性分析

Clinical distribution and drug-resistance analysis of Acinetobacter baumannii isolated from our hospital in 2014

目的分析该院2014年鲍曼不动杆菌感染的临床特点及耐药趋势,从而促进临床合理使用抗菌药物。方法对2014年该院临床标本中分离的鲍曼不动杆菌进行回顾性分析。应用MicroScan WalkAway-40SI的NC31板对分离出的细菌进行鉴定,并以MIC法及K-B法进行药物敏感试验,按CLSI 2010年版标准对药敏结果进行判断。结果全年共分离鉴定鲍曼不动杆菌299株,检出率在痰液中最高(89.63%);临床分布以重症监护病房(ICU)最多(55.18%),其次是神经外科(17.39%);药敏结果显示其对亚胺培南、美洛培南的耐药率分别为52.17%和56.86%,对β-内酰胺类、喹诺酮类和氨基糖苷类的耐药率均高于60%,对含酶抑制剂敏感度较高,其中耐药率最低的是头孢哌酮/舒巴坦(5.02%)。结论鲍曼不动杆菌检出率及耐药率呈上升趋势,对常用抗菌药物耐药情况严重;各病区应加强鲍曼不动杆菌耐药监测,防止耐药菌的播散流行。

Objective To analyze the clinical characteristics of acinetobacter baumannii infection and drug resistance tendency of our hospital in 2014,so as to promote the clinical rational use of antibiotics.Methods The study was a retrospective review,the results of clinical distribution and drug resistance of acinetobacter baumannii isolated from our hospital in 2014 were analyzed.The antimicrobial susceptibility testing（AST）of acinetobacter baumannii was determined by K-B disk diffusion method and minimal inhibitory concentration（MIC）test,respectively.The AST was performed as recommended by CLSI 2010.Results A total of 299 strains of acinetobacter baumannii were isolated from clinical specimens throughout the year.Of the 299 Acinetobacter baumannii isolates,268strains（89.63%）were isolated from sputum,165strains（55.18%）of Acinetobacter baumannii were from intensive care unit（ICU）and 52strains（17.39%）were from neurosurgery.The resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was 5.02% while its resistance to Imipenem and Meropenem significantly increased to 52.17% and 56.86%,respectively.And the resistance rates of β-lactams,fluoroquinolones and aminoglycosides were higher than 60%.Conclusion The isolation rate of Acinetobacter baumannii is increasing in recent year in our hospital,as well the resistance rate to the common Antibiotics.Monitoring the resistance of Acinetobacter baumannii should be strengthened for preventing resistant bacteria from spreading.