珠海地区2014—2016年鲍曼不动杆菌的临床分布及耐药性分析

Clinical distribution and drug resistance of Acinetobacter baumannii in Zhuhai, 2014-2016

目的探讨珠海地区鲍曼不动杆菌的临床分布和耐药情况,为预防和控制医院感染,合理使用抗生素提供依据。方法收集珠海地区3家三甲医院临床分离的非重复鲍曼不动杆菌1 094株,采用纸片扩散法测定菌株对抗生素的敏感性,采用WHONET 5.4软件分析数据。结果 2014—2016年共分离出1 094株鲍曼不动杆菌,主要分离来自痰液(74.3%);科室分布以重症监护病房(73.4%)和呼吸内科(15.9%)为主;鲍曼不动杆菌对15种常用抗生素的耐药性较高,且逐年增长;但对多菌粘素B和米诺环素的耐药率最低。2014—2016年分别检出多重耐药鲍曼不动杆菌211株(61.7%),237株(64.6%)和268株(69.6%),泛耐药鲍曼不动杆菌146株(42.7%),188株(51.2%)和203株(52.7%)。结论鲍曼不动杆菌是珠海地区重要的院内感染病原菌,耐药率较高,该菌以引起呼吸系统感染为主。临床应根据药敏结果合理使用抗生素,减少鲍曼不动杆菌的感染和耐药菌株产生。

Objective To investigate the infection and drug resistance of Acinetobacter baumannii in Zhuhai area, so asto provide the evidence for the rational administration of antibiotics and prevention and control of hospital infection. Methods A total of 1 094 non-duplicate strains of Acinetobacter baumannii were collected. The antimicrobial susceptibility wasdetermined by the disk diffusion method. The antimicrobial susceptibility data was analyzed by WHONET 5.4. Results Totally 1 094 strains of Acinetobacter baumannii were isolated in our hospital from 2014 to 2016, and they were mainly derivedfrom sputum samples（74.3%）, and distributed in ICU（73.4%） and respiratory medicine department（15.9%）. Acinetobacter baumannii showed totally high drug resistance to 15 kinds of common antibiotics, and during the 3 years, the resistant ratesbasically kept an increasing trend. Acinetobacter baumannii had low resistance to polymyxin B and minocycline. Every year（in2014, 2015 and 2016）, 211（61.7%）, 237（64.6%） and 268（69.6%） strains of multidrug-resistant Acinetobacter baumannii and146（42.7%）, 188（51.2%） and 203（52.7%） strains of pan-drug-resistant Acinetobacter baumannii were detected, respectively.Conclusion Acinetobacter baumannii is the main pathogen of hospital acquired infections and its drug resistance rate is higherin Zhuhai area. Acinetobacter baumannii mainly causes respiratory system infection. The clinicians should rationally chooseantibacterial agents according to the susceptibility test results so as to reduce the Acinetobacter baumannii infection and itsdrug resistance.