我院抗菌药物使用与鲍曼不动杆菌耐药的相关性分析

Correlation analysis of drug resistance of Acinetobacter baumannii to the mainly used antibiotics in our hospital

目的了解近6年来鲍曼不动杆菌的检出分布及对主要抗菌药物的敏感性趋势,为临床合理使用抗菌药物和医院感染防控提供科学依据。方法回顾性分析2011~2016年临床分离的鲍曼不动杆菌的标本分布情况,以K-B纸片扩散法检验其耐药性,观察鲍曼不动杆菌对主要抗菌药物的敏感趋势。结果共分离出2 732株鲍曼不动杆菌,分离率为16.74%,鲍曼不动杆菌主要来自痰标本(84.81%)。美罗培南和哌拉西林/他唑巴坦的使用量逐年递增,而鲍曼不动杆菌对这2种抗菌药物的敏感性逐年降低,差异有统计意义;鲍曼不动杆菌对左氧氟沙星的敏感性从趋势图上看呈负相关,差异无统计学意义。结论鲍曼不动杆菌的耐药情况不容乐观,美罗培南和哌拉西林/他唑巴坦的使用可能会进一步加剧其耐药的产生,建议临床医生谨慎选择这2种抗菌药物。

Objective To investigate the distribution of Acinetobacter baumannii and the sensitivity to the main antimicrobial agents in our hospital in the past6years,and to provide a basis for clinical anti-infection treatment.Methods The distribution of clinically isolated Acinetobacter baumannii and the sensitivity of the main antimicrobial agents in our hospital from2011to2016were retrospectively analyzed.The drug resistance was tested by K-B paper diffusion method,and the sensitive trend of Acinetobacter baumannii to the main antibiotics was observed.Results There were2732strains Acinetobacter baumannii isolation,and the constituent ratio was16.74%.Acinetobacter baumannii was mainly isolated from sputum specimens,and the composition ratio was84.81%.The use of meropenem and piperacillin/tazobactam in our hospital increased year by year,but Acinetobacter baumannii sensitivity to these two antibiotics decreased year by year,the difference was statistically significant.While the sensitivity of Acinetobacter baumannii to levofloxacin was negatively correlated with the trend,but had no statistically significant difference.Conclusion The drug resistance of Acinetobacter baumanniiis is serious.The use of meropenem and piperacillin/tazobactam may exacerbate the drug resistance.It is recommended that clinicians should carefully select these2drugs when using antimicrobial agents by experience.