499株鲍曼不动杆菌临床分布及耐药性分析

Analysis on infection distribution and drug resistance of 499 strains Acinetobacter baumannii

目的了解湖南省脑科医院2013年至2015年鲍曼不动杆菌的临床分布及其耐药性,指导临床合理使用抗生素。方法收集医院2013年1月至2015年12月分离的499株鲍曼不动杆菌,分析其临床分布及耐药性。结果分离的499株鲍曼不动杆菌中,2013年158株,占31.7%;2014年184株,占36.8%;2015年157株,占31.5%。主要来源于痰液77.15%(385株)和伤口分泌物7.41%(37株);科室分布以ICU27.25%(136株)、呼吸内科22.04%(110株)和神经外科15.43(77株)为主;分离菌株对妥布霉素的敏感率最高,其次为哌拉西林/他唑巴坦和亚胺培南;2013年至2015年鲍曼不动杆菌的广泛耐药的比例分别为15.8%、12.5%和26.8%。结论鲍曼不动杆菌的耐药率较高,且呈广泛耐药趋势,应加强耐药性监测,以药敏试验结果指导临床用药,有助于减少耐药菌株的出现。

Objective To investigate the distribution and drug resistant of Acinetobacter baumannii in our hospital, and to provide guidance for the reasonable use of antibiotic drugs in clinic. Methods 499 strains Acinetobacter baumannii from January 2013 to December 2015 in our hospital were collected , and the distri-bution and drug resistant were analyzed by WHONET 5.6 analyzer. Results 499 strains Acinetobacter bau-mannii were isolated, among which there were 158 strains in 2013（31.7%）, 184 strains in 2014（36.8%）, and 157 strains in 2015 （31.5%）. The Acinetobacter baumannii mainly isolated from sputum （385 strains, 77.15%）, and wound secreta （37 strains, 7.41%）. While the top three clinics were ICU （136 strains, 27.25%）, respiration medicine （110 strains, 22.04%） and neurosurgery （77 strains, 15.43%）. The Acineto-bacter baumannii were high sensitive to tobramycin, then piperacillin and tazobactam, and imipenem. The rates of extensive drug resistance from 2013 to 2015 were 15.8%, 12.5%, and 26.8%. Conclusion Acineto-bacter baumannii is high resistance to antibiotic. Drug resistance surveillance should be strengthened to guide the clinical medication.