鲍曼不动杆菌临床易感因素及耐药性分析

Analysis of clinical susceptible factors and drug resistance of Acinetobacter baumannii

目的:了解鲍曼不动杆菌临床分布特点及耐药性情况,为临床抗菌药物合理使用提供参考。方法:回顾性分析临床分离的鲍曼不动杆菌患者基本信息,使用VITEK-2分析耐药性。结果:共分离出鲍曼不动杆菌110株,以痰液标本检出率最高,占74.5%;其次是分泌物标本,占14.6%。科室主要集中在ICU、烧伤整形科,分别占61.8%、10.0%。临床分离的鲍曼不动杆菌表现出高的耐药率,除对亚胺培南、复方新诺明和阿米卡星的耐药率分别为29.1%、28.2%、36.4%以外,对其它抗菌药物左氧氟沙星、环丙沙星、哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、头孢噻肟、哌拉西林、氨曲南的耐药率都在40%以上,对头孢哌酮/舒巴坦耐药率最低。结论:鲍曼不动杆菌感染在重症监护病房最为严重,其次是烧伤整形科,对多种抗菌药物耐药率高,患有严重基础疾病、骨折创伤、大面积烧伤等是其易感的危险因素,应加强耐药监测及相关防控措施,避免耐药谱扩大。

Objective:To understand the clinical distribution and drug resistance of Acinetobacter baumannii,so as to provide reference for rational use of antibiotics in clinical.Methods:We retrospectively analyzed the basic information of clinical isolates of Acinetobacter baumannii and analyzed drug resistance using VITEK-2.Results:A total of 110 strains of Acinetobacter baumannii were isolated,The highest detection rate of sputum sample was 74.5%;followed by the secretion sample,accounting for 14.6%.The departments were mainly concentrated in the ICU,Burns and Plastic Surgery,accounting for 61.8%and 10.0%respectively.The clinical isolates of Acinetobacter baumannii showed high drug resistance,except for the imipenem,cotrimoxazole,and Amikacin drug resistance rates were 29.1%,28.2%,36.4%.Drug resistant rates of levofloxacin,ciprofloxacin,piperacillin/tazobactam,cefepime,ceftazidime,cefotaxime,piperacillin,and aztreonam were all above 40%,For cefoperazone/sulbactam has the lowest resistance rate.Conclusion:Acinetobacter baumannii infection is the most serious in the ICU,followed by Burn and Plastic Surgery.The high drug resistance rate for many kinds of antibiotics,indicates serious drug resistance.Patients with severe underlying diseases,fracture trauma,extensive burns are risk factors for susceptibility,Drug resistance monitoring and related prevention and control measures should be strengthened to avoid further expansion of drug resistance spectrum.