鲍曼不动杆菌3年耐药性监测结果分析

Drug resistance monitoring and results analysis of Acinetobacter baumannii for 3 years

目的了解近3年鲍曼不动杆菌的分布特征及对临床常用抗菌药物的耐药性,为临床合理用药、控制院内感染提供理论依据。方法采用VITEK 2全自动微生物分析仪及配套卡片对本院2015年1月-2017年12月住院患者分离的鲍曼不动杆菌进行标本来源、临床科室分布及药敏试验结果分析。结果 1 044株鲍曼不动杆菌感染部位主要在下呼吸道,痰和咽拭子标本检出率为87. 9%;科室分布主要在重症监护室、呼吸内科、神经内科,分别占44. 3%、27. 2%、15. 6%。对氨苄西林、头孢西丁、头孢唑啉、呋喃妥英(坦丁)、阿莫西林/棒酸耐药率近3年均高度耐药,对头孢吡肟、复方新诺明、妥舒沙星、替加环素耐药率呈逐年下降趋势,耐药率最低为替加环素。结论该院鲍曼不动杆菌的感染率高,其耐药性及多药耐药性严重,临床应加强细菌耐药性监测,根据药敏结果合理选择抗生素,采取联合和交替用药,以提高疗效和控制耐药。

Objective To understand the distribution characteristics of Acinetobacter baumannii and drug resistance to clinical antibiotics in recent 3 years, so as to provide theoretical basis for rational drug use and control of nosocomial infections. Methods VITEK- 2 automatic microorganism analyzer and matching cards were used to analyze the sources, distribution of clinical departments and drug sensitivity test results of Acinetobacter baumannii isolated from inpatients in our hospital from January 2015 to December 2017. Results The infection sites of 1 044 Acinetobacter baumannii were mainly the lower respiratory tract, and the detection rate of sputum and pharynx swabs was 87.9% ; the main sections were in the intensive care unit, the respiratory department and the neurology department, which accounted for 44.3%, 27.2% and 15.6% , respectively. The resistance rate of nearly three annual years kept high to ampicillin, cefoxitin, cefazohn, nitrofurantoin（ tandien）, amoxici｜lin/ clavulanic acid, the drug resistance rate to cefepime, compound noxoxin, doxofloxacin and tenacycline decreased year by year, and the lowest drug resistance rate was observed to tetracycline. Conclusion The infection rate of Acinetobacter baumannii is high, and its drug resistance and multidrug resistance are severe. We should strengthen the monitoring of bacterial resistance, choose antibiotics rationally according to the drug sensitivity, take joint and alternate medication, so as to improve efficacy and control drug resistance .