2011—2016年某三甲医院鲍曼不动杆菌临床分布及耐药性变迁

Clinical Distribution and Drug-resistance Analysis of Acinetobacter Baumannii From 2011 to 2016

目的了解某三甲医院2011年1月—2016年12月临床分离的鲍曼不动杆菌临床分布特征及其对多种抗菌药物耐药性变迁,为临床合理用药提供依据。方法收集近6年某三甲医院临床分离的住院病人鲍曼不动杆菌相关资料,用WHONET 5.6及SPSS16.0软件分析其临床分布及耐药性变迁。结果在检出的714株鲍曼不动杆菌中,临床科室分布以重症监护室(ICU)为主,占50.84%,其次为呼吸内科,占9.66%;标本来源分布主要为痰标本,占78.2%;在临床使用的抗生素中,除四环素类耐药率较低,其他包括碳青霉烯类、氨基糖苷类、喹诺酮类均>50%,特别是ICU科室,对12种抗菌药物的耐药性及耐碳青霉烯类鲍曼不动杆菌检出率明显高于非ICU科室(P<0.005)。结论鲍曼不动杆菌临床分布广泛、且多耐药、泛耐药趋势明显,不同科室耐药率差异较大,应加强对耐药性监测,合理使用抗菌药物。

Objective To Inverstigate the distribution characteristics and drug-resistance of Acinetobacter baumannii isolated from a hospital, to provide evidence for rational use of antibacterials in clinical practice. Methods A retrospective analysis was conducted, data of Acinetobacter baumannii isolated from hospitalized patients in a hospital in recent 6 years were collected, and clinical distribution and drug-resistance were analyzed by WHONET 5.6 and SPSS16.0 software. Results In the 714 Acinetobacter Baumanii isolates, 363 strains（50.84%） were from intensive care unit （ICU）, followed by the department of respiratory medicine（9.66%）. 558 strains（78.2%） were isolated from sputum. Among the clinically used antibiotics, the resistance rate to most of antibiotics were 〉50%, including carbapenems, aminoglycosides and quinolones, especially in the ICU. The drug-resistance rate to 12 antibiotics and the detection rate of carbapenem-resistant Acinetobacter baumannii was significantly higher than that of non-ICU（P（0.005）. Conclusion The clinical distribution of Acinetobacter baumannii is widely distributed, and the trend of multidrug resistance and multidrug resistance is obvious,The difference of resistance rate between different departments was obvious. It＇s necessary to strengthen the monitoring of drug resistance and use antibiotics reasonably.