多药耐药鲍曼不动杆菌的临床分布与耐药性监测

Clinical Distribution and Drug Resistance of Multidrug Resistant Acinetobacter Baumannii in Bauman

目的了解我院临床分离的鲍曼不动杆菌(ABA)的临床分布及耐药性特点,指导临床合理使用抗菌药物,预防及减少医院感染的发生。方法采用VITEK2 compact全自动细菌分析仪对我院住院患者的标本进行分离鉴定和药敏试验。结果 2011年1月至2016年3月临床送检的各类标本中共分离出鲍曼不动杆菌546株,其中多药耐药鲍曼不动杆菌(MDR-AB)203株占37.2%,泛耐药鲍曼不动杆菌(PDR-AB)45株占8.2%。203株MDR-AB的标本来源主要为痰液,共183株占90.2%。其次为尿液,共9株占4.4%。病区分布以重症监护病房(ICU)为主,共80株占39.4%。其次为内科,共65株占32.0%。MDR-AB对氨苄西林、头孢替坦和头孢呋新钠抗菌药物显示完全耐药,耐药率为100%。对头孢菌素类的抗菌药物的耐药率>50%以上。对其他的抗菌药物的耐药率均<50%以下,显示了较高的抗菌活性。结论鲍曼不动杆菌对多种抗菌药物均显示了较高的耐药性,而且多药耐药及泛耐药株不断产生,应引起临床医师的高度重视。同时,临床医师应根据药敏试验结果有针对性地选择抗菌活性较强的抗菌药物或采取联合用药进行治疗。及时控制其感染,严格消毒制度,认真执行无菌操作,遏制多药耐药菌和泛耐药菌的产生与流行。

Objective Understand our clinical separated acinetobacter baumannii（ABA） the clinical distribution and drug resistance characteristics, to guide clinical rational use of antimicrobial agents, to prevent and reduce the occurrence of hospital infection. Methods The VITEK2 compact compact autobacterial analyzer was used to isolate the specimens of the patients in our hospital. Result In January 2011-March 2016 makes clinical specimens of all kinds of the isolated 546 strains of acinetobacter baumannii, the multi-drug resistant acinetobacter baumannii（MDR-AB） 203 strains（37.2%）, generic drug resistant acinetobacter baumannii（PDR-AB） 45 strains（8.2%）. The 203 mdr-ab samples were mainly derived from sputum, which accounted for 90.2 percent of the population. The second was urine, which accounted for a total of 4.4 percent. The disease area was distributed in intensive care unit（ICU）, which accounted for 39.4% of the total population. In the second, the total 65 strains were 32.0 percent. MDR-AB showed complete resistance to antibacterial antibacterial agents of ampicillin, ceftitan and cefuroxime, with 100% tolerance. Antimicrobial resistance of cephalosporin drugs was more than 50%. The tolerance rate of other antimicrobial agents was less than 50% and showed higher antimicrobial activity. Conclusion Acinetobacter baumannii were showed high resistance to many kinds of antimicrobial agents, and multi-resistant and resistant strains emerge, should be more attention from clinical doctors. At the same time, the clinician should choose the antibacterial drugs that are active in antibacterial activity and the combination drug to be treated according to the results of the drug test. To control the infection in time, strictly sterilize the system, carry out the sterile operation conscientiously, and restrain the production and popularity of multidrug resistant bacteria and generics.