铜绿假单胞菌和鲍曼不动杆菌感染分布特征及耐药性分析

Distribution characteristics and antimicrobial resistance of Pseudomonas aeruginosa and Acinetobacter baumannii

目的探讨铜绿假单胞菌和鲍曼不动杆菌的分布特征及对多种抗菌药物的耐药性变迁。方法收集2012年1月至2014年12月该院分离的铜绿假单胞菌和鲍曼不动杆菌,采用琼脂扩散法做药物敏感试验,比较其对抗菌药物的耐药性变迁。结果共分离出病原菌3 710例,铜绿假单胞菌分离214株(5.8%),鲍曼不动杆菌分离347株(9.4%)。铜绿假单胞菌3年感染率分别为7.3%、6.6%、4.7%,呈逐年减少趋势,鲍曼不动杆菌感染率分别为7.6%、8.8%、10.3%,呈逐年增加趋势。标本来源主要以痰液、创面分泌物、尿液为主。铜绿假单胞菌和鲍曼不动杆菌感染菌株以重症监护室(ICU)检出率最高,分别为27.6%和34.9%。铜绿假单胞菌对头孢他啶、阿米卡星、亚胺培南的耐药率均有逐年增高趋势;鲍曼不动杆菌对哌拉西林/他唑巴坦、亚胺培南耐药率逐年增高;多粘菌素B耐药率逐年下降。结论铜绿假单胞菌和鲍曼不动杆菌对抗菌药物耐药率逐年增高,尤其对碳青霉烯类耐药情况日趋严重,因此需加强对铜绿假单胞菌及鲍曼不动杆菌的耐药性监测,指导临床合理应用抗菌药物。

Objective To analyze the distribution characteristics of Pseudomonas aeruginosa and Acinetobacter baumannii,and to investigate the changing pattern of antimicrobial resistance of these strains isolated during 2012-2014.Methods Strains of Pseudomonas aeruginosa and Acinetobacter baumannii isolated from January 2012 to December 2014 were collected.Antimicrobial susceptibility of clinical isolates was tested by Kirby-Bauer method.Results In the past three years,214 strains of Pseudomonas aeruginosa and 347 strains of Acinetobacter baumannii were isolated.The nosocomial infection rate of Pseudomonas aeruginosa decreased year by year,while the Acinetobacter baumannii′s increased.Most strains were isolated from sputum,wound secretion and urine.The strains of Pseudomonas aeruginosa and Acinetobacter baumannii were distributed in various departments of the hospital.The detection rates of these strains were the highest in ICU,respectively 27.6% and 34.9%.Both the resistance rates of Pseudomonas aeruginosa to ceftazidime,imipenem,Amikacin and Acinetobacter baumannii to Piperacillin/Tazobactam and imipenem had increased,while the resistance rates of Acinetobacter baumannii to polymyxin B had decreased with each passing year.ConclusionPseudomonas aeruginosa and Acinetobacter baumannii causes severe nosocomial infections and the antimicrobial resistance rates increased,especially the resistance rates to carbapenem are becoming more higher in recent years.Acinetobacter baumannii shows strong antibacterial activity in vitro to Polymyxin B.Therefore,antimicrobial resistance surveillance should be strengthened to direct rational use of antibiotics.