2012～2016年鲍曼不动杆菌分布及耐药变化趋势分析

Spectral Distribution of Acinetobacter Baumannii and Its Antibiotic Resistance in Recent Five Years

目的对2012~2016年医院患者鲍曼不动杆菌(AB)感染现状及耐药性进行调查,为感染监控和临床用药提供参考。方法回顾性分析2012~2016年医院患者细菌培养标本中AB的分离情况及耐药性的变迁趋势。结果 2012~2016年临床共分离AB 2 168株,分离率2012~2014年逐年上升,而2014~2016年则呈逐年下降趋势,临床分离的AB主要来源于痰标本,分离AB阳性率较高的病区是重症医学科、神经外科、呼吸科、老年病科和骨科等,AB对大多数抗菌药物的耐药率>70%,耐药率最低的是头孢哌酮/舒巴坦,2012~2016年AB的多重耐药率呈逐年上升趋势。结论虽然本院的鲍曼不动杆菌临床分离率有下降趋势,但多重耐药率仍逐年上升,说明鲍曼不动杆菌的耐药形势严峻,需引起各相关科室高度重视,临床应根据药物敏感性试验结果合理使用抗菌药物。

Objective To investigate the current epidemic situation of hospital infection of Acinetobacter baumannii and its resistance to antibiotics in order to provide reference for clinical treatments. Methods The retrospective analyses were performed based on the sample isolations and bacterial cultures from inpatients in the hospital from 2012 to 2016. Results A total of 2168 bacterial strains were collected. The positive rate was found to annually increase from 2012 to 2014 but it showed a gradual decrease from 2014 to 2016. Clinical isolates ofA. baumannii were mainly from sputum samples. The majority of isolates came from the critical care medicine, neurosurgery, pulmonary infections, orthopedics, and geriatrics. The resistance rate of A. baumannii to antibiotics that are currently used was as high as 70 percent. The bacterial resistance to Cefoperazone was the lowest of all isolates. Conclusion The frequency of multiple drug resistance seems to be rising in spite of the decreased A.baumannii isolation in the hospital surveyed, indicating an urgent need of clinician use of antibiotics based on sensitivity test.