血流感染的鲍氏不动杆菌对11种抗菌药物的耐药性变迁

Evolution of antibiotic susceptibility of Acinetobacter baumannii isolated from inpatients with bloodstream infections

目的研究引起血流感染的鲍氏不动杆菌对11种抗菌药物的耐药性变迁,为临床合理使用抗菌药物提供流行病学资料。方法回顾性分析2009-2014年医院确认为血流感染的住院患者中分离的鲍氏不动杆菌非重复菌株的临床分布特征和对11种抗菌药物的体外药敏结果,采用WHONET 5.6软件进行数据统计分析。结果2009-2014年住院患者血液标本共分离出来自18个科室的136株鲍氏不动杆菌,检出株数排名前3位的科室是中心监护室,呼吸内科监护室,神经外科监护室;鲍氏不动杆菌对氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、亚胺培南、美罗培南等抗菌药物的耐药率均>70.00%;多药耐药菌株共102株占75.0%,有逐年增多趋势。结论鲍氏不动杆菌的检出逐渐增加,多药耐药菌的检出率也逐年升高,总体耐药性趋势上升,因此,临床应合理选择抗菌药物,避免多药耐药菌和泛耐药菌的发生。

OBJECTIVE To investigate the evolution of antibiotic resistance of Acinetobacter baumannii isolated from inpatients with bloodstream infections to 11 kinds of antibiotics,so as to provide epidemiological data for the rational use of antibiotics.METHODS Clinical distribution characteristics and in vitro antibiotic susceptibility of A.baumannii isolated from inpatients with bloodstream infections from Jan.2009 to Dec.2014 to 11kinds of antibiotics were retrospectively analyzed.The WHONET5.6software was used for data statistical analysis.RESULTS A total of non-duplicated 136 strains of A.baumannii were isolated from patients with bloodstream infections from18 departments from 2009 to 2014,and the top 3departments were intensive care unit,respiration,and neurosurgery.The drug resistant rates of A.baumannii to ampicillin/sulbactam,piperacillin/tazobactam,ceftazidime,cefepime,imipenem,meropenem were all above 70.00%.Totally 102（75.0%）isolates were found multi-drug resistance（MDR）and the MDR strains was increased with years from 2009-2014.CONCLUSION The detection rate of A.baumannii was gradually increased,detection rate multidrug-resistant bacteria was also increased year by year,and the overall trend of drug resistance was increased,therefore,clinical antibiotics should be selected rationally to avoid the occurrence of multidrug-resistant bacteria and pan-resistant bacteria.