鲍曼不动杆菌对抗生素的耐药性监测  

The resistance of Acinetobacter baumannii to 16 antibiotics

作　　者：应易高[1] 徐晓雯[2] 徐兆余[2] 

机构地区：[1]上海市杨浦区中心医院院内感染管理科,上海200090 [2]上海市杨浦区中心医院呼吸科,上海200090

出　　处：《同济大学学报（医学版）》2007年第4期80-84,共5页Journal of Tongji University(Medical Science)

摘　　要：目的调查鲍曼不动杆菌(acinetobacter baumannii,Ab)对16种抗生素的耐药情况。方法收集我院2005年1月至2006年6月分离的288株鲍曼不动杆菌,其中社区感染株(community acquired infection,CAI)237株,医院感染株(hospital acquired infection,HAI)51株。按《全国检验技术操作规程》要求操作,用细菌鉴定仪鉴定菌种,采用K-B法做药敏试验。结果Ab对几乎所有半合成青霉素、头孢菌素、碳青霉烯类、氨基糖苷类、氟喹诺酮类均具有较高水平的耐药性,对其他酶抑制剂复合制剂亦不敏感。对亚胺培南敏感率最高为68.5%,其余抗生素的敏感率都<54.5%。绝大多数病原菌医院内感染株的耐药率高于社区感染株,两者之间差别有统计学意义(P<0.01)。结论近期我院经验性治疗首选阿莫西林/舒巴坦+左氧氛沙星+阿米卡星或SMZCO组合治疗方案。Objective To investigate the antimicrobial susceptibility of 16 antimicrobial agents in Acinetobacter baumannii isolated from hospitalized patients. Methods From January 2005 to June 2006,288 strains of Acinetobacter baurnannii, including 237 of community acquired infection（CAI）and 51 of hospital acquired infection（HAI）were analyzed according to the requirements described in the National Regulations on Clinical Laboratory Operations. The bacteria were identified by the automated analyzer VITEK-32 made by Bio-Merieux Company in France and the drug resistance were analyzed with K-B test. Results Ab had high resistance to semisynthetic penicillin, cephalosporins, carbapenems, aminoglycosides, fluoroquinolones, and multiplicity enzyme inhibitor. The sensitive rate of Acinetobacter baumannii to imipenem was 68.5 % while the sensitive rate to other antibiotics was down to 54.5 %. The resistant rates of most isolates from nosocomial infectious patients were higher than those from community infectious patients, and there was a significant difference between them（P〈 0.01 ）. Conclusion In the near future, the first choice in this hospital should adopt amoxicillin/sulbactam ＋ Levofloxacin ＋ Amikacin or SMZCO as a combined treatment for nosocomial infectious.

关 键 词：鲍曼不动杆菌 耐药性 碳青酶烯类 

分 类 号：R978.1[医药卫生—药品]