某院近三年鲍曼不动杆菌临床分布及耐药性分析

Clinical distribution and drug resistance of Acinetobacter baumannii during 3 years

目的：了解近3年鲍曼不动杆菌的临床分布及耐药性变迁,指导临床合理使用抗菌药物。方法：回顾性分析2012-2014年该院住院患者鲍曼不动杆菌感染的相关数据,用Kirby-Bauer法进行药敏试验,采用WHONET 5.4软件对药敏试验结果进行统计分析。结果：3年共分离鲍曼不动杆菌182株,主要分离自痰液（50株）、血液（45株）、尿液（42株）、伤口分泌物（31株）及其他标本（14株）;主要分布于重症监护室（ICU）53株（29.1%）,呼吸内科47株（25.8%）,外科36株（19.8%）及骨伤科30株（16.5%）等。鲍曼不动杆菌对多种抗菌药物的耐药率均〉70%,且均出现多重耐药;对亚胺培南的耐药率高达60.5%;耐药率相对较低的有美罗培南、粘菌素和米诺环素（均≤50%）。结论：3年间鲍曼不动杆菌检出率逐年增多且总体耐药性呈上升趋势,对多种药物耐药率高,多重耐药情况严重。连续监测鲍曼不动杆菌临床分布及耐药性变迁有助于指导临床合理使用抗菌药物。

Objective The aim was to investigate the clinical distribution and the changing trends of drug resistance of Acinetobacter baumannii,And to guide drug treatment in clinic. Method The distribution and drug resistance of Acinetobacter baumannii were analyzed from 2012 to 2014,and its antimicrobial resistance was determined by Kirby-Bauer method. All date were analyzed statistically by WHONET 5. 4 software. Results A total of 182 strains of A. baumannii were isolated during the three years,and most of them were isolated from sputum（50 strains）,blood（45 strains） and urine（42 strains）; The distribution of A. baumannii was in ICU（29. 1%）,respiratory medicine（25. 8%）,surgery department（19. 8%） and orthopedics and traumatology department（16. 5%）. Antibiotic resistant rate of A. baumannii to most of drug were higher than 70. 0%,and most of them were multi-drug resistance. The drug resistant rate of A. baumannii to imipenem was up to 60. 5%. The lowest drug resistant rate was meropenemm、polymyxin and minocycline（all ≤50%）. Conclusion The isolating and the drug resistant rate of A. baumannii are increasing. These strains are highly resistant to multiple antibiotics. Therefore we must continual monitor the distribution and drug resistance of A. baumannii in clinic. So as to guide rational use of antibiotics in clinic.