血流感染鲍氏不动杆菌耐药性分析

Drug resistance of Acinetobacter baumannii causing bloodstream infections

目的 了解引起血流感染的鲍氏不动杆菌对抗菌药物耐药性变迁,为临床合理使用抗菌药物提供依据。方法 回顾性分析2009年1月-2013年12月血培养阳性分离出的93株非重复鲍氏不动杆菌,对致病菌株进行鉴定及药敏试验,采用WHONET5.6软件进行数据分析,结果按CLSI2014年版标准判读。结果 2009-2013年分离出的93株鲍氏不动杆菌主要来自ICU40例占43.0%,其次分别来自外科29例占31.2%、内科16例占17.2%、急诊8例占8.6%;所有鲍氏不动杆菌血流感染患者对常用头孢菌素、半合成青霉素＋酶抑制剂、喹诺酮类及碳青霉烯类抗菌药物耐药性达56.9%~92.3%,对多粘菌素B耐药率最低。结论 鲍氏不动杆菌血流感染耐药情况严重,临床应合理使用抗菌药物,减少耐药菌株的产生。

OBJECTIVE To understand the change of drug resistance of Acinetobacter baumannii strains causing bloodstream infections so as to provide guidance for reasonable clinical use of antibiotics. METHODS A total of 93 strains of non-fermenting A. baumannii that were isolated from blood specimens from Jan 2009 to Dec 2013 were retrospectively analyzed, then the pathogenic strains were identified, the drug susceptibility testing was per- formed, and the data were analyzed by using WHONET5.6 software. RESULTS Of the 93 strains of A. baumannii isolated from 2009 to 2013, 43.0% were isolated from 40 ICU patients, 31.20% were isolated from 29 surgery de- partment patients, 17.2% were isolated from 16 internal medicine department patients, and 8.6% were isolated from 8 emergency department patients. The drug resistance rates of the A. baumannii strains causing the blood- stream infection to cephalosporins, semi-synthetic penicillin plus enzyme inhibitor, quinolones, and carbapenems varied from 56.9% to 92. 3%% the drug resistance rate to polymyxin B was the lowest. CONCLUSION The A. baumannii strains causing the bloodstream infection are highly drug-resistant. It is necessary for the hospital to reasonably use antibiotics so as to reduce the drug-resistant strains.