2006～2009年鲍曼不动杆菌感染分布特征及耐药性变迁  

Changes of antimicrobial agents resistance and distribution feature among acinetobacter baumannii Isolated during 2006～2009

作　　者：马玲[1] 袁喆[1] 

机构地区：[1]重庆医科大学附属第一医院感染科、重庆市传染病寄生虫病学重点实验室,重庆400016

出　　处：《重庆医科大学学报》2010年第8期1278-1281,共4页Journal of Chongqing Medical University

基　　金：重庆市自然科学基金(编号:2009BB5061)

摘　　要：目的:研究2006～2009年临床分离鲍曼不动杆菌(Acinetobacter baumannii,A.b)的分布特征及对抗菌药物的耐药性变迁,比较多粘菌素B与亚胺培南对多重耐药鲍曼不动杆菌的体外抗菌活性。方法:监测近4年来临床分离鲍曼不动杆菌感染分布特征。采用纸片琼脂扩散法药敏试验,分析鲍曼不动杆菌对抗菌药物敏感性,比较近4年来鲍曼不动杆菌对抗菌药物的耐药性变迁。采用常量肉汤稀释法测定多粘菌素B及亚胺培南对多重耐药鲍曼不动杆菌的最低抑菌浓度(Minimal inhibitory concentration,MIC)值,比较其体外抗菌活性。结果:近4年来,鲍曼不动杆菌感染占临床分离革兰阴性杆菌的构成比逐年增加,以ICU病房患者呼吸道标本检出率最高。临床分离鲍曼不动杆菌对亚胺培南的耐药率从2008年起明显上升,多重耐药鲍曼不动杆菌比例也逐渐增加。比较多粘菌素B及亚胺培南对多重耐药鲍曼不动杆菌的体外抗菌活性显示,多粘菌素B对多重耐药鲍曼不动菌株的敏感率为93.8%,多粘菌素B对多重耐药鲍曼不动杆菌的体外抗菌活性明显高于亚胺培南。结论:鲍曼不动杆菌在医院感染所占的比例明显上升。鲍曼不动杆菌对临床常用抗菌药物的耐药性也呈逐年上升趋势,多重耐药菌比例明显增加。应加强鲍曼不动杆菌细菌耐药监测。多粘菌素B对多重耐药鲍曼不动杆菌仍呈现出较强的体外抗菌活性,对于多重耐药鲍曼不动杆菌引起的严重感染可以考虑使用多粘菌素B治疗。Objective：To investigate the Acinetobacter baumannii’s distribution feature、the antimicrobial resistance of Acinetobacter baumannii isolated during the past 4 years and compare antibacterial activity of Polymyxin B against multidrug-resisitant（MDR） Acinetobacter baumannii with that of Imipenem in vitro.Methods：The distribution feature of infection caused by Acinetobacter baumannii was supervised.Disk diffusion test was used to study the antimicrobial agents resistance of Acinetobacter baumannii and transition of drug resistance.The results were evaluated based on Clinical and Laboratory Standards Institute（CLSI）.The MDR Acinetobacter baumannii were screened by WHONET 5.MICs（minimal inhibitory concentration）of Polymyxin B and imipenem were detected by broth dilution method.Results：Constituent ratio of infections caused by Acinetobacter baumannii had been incresed in the recent 4 years,especially in intensive care unit.Although carbapenems were the most active antibiotics tested against Acinetobacter baumannii,the resistance rate had been sharply raised since 2008.In addition,the ratio of MDR Acinetobacter baumannii had also been raised in the 4 years.The results of MIC displayed that Polymyxin B had the higher antibacterial activity against the MDR Acinetobacter baumannii than Imipenem. Conclusion：Proportion of nosocomial infection caused by Acinetobacter baumannii significantly increased.The resistance rate of Acinetobacter baumannii had been rised obviously and the number of MDR Acinetobaeter baumannii had been increased sharply. Monitoring of the antimicrobial agents resistance to Acinetobacter baumannii should be strengthened.Polymyxin B still shows strong antibacterial activity on the MDR Acinetobacter baumannii in vitro.We can consider using Polymyxin B to treat the severe infections caused by MDR Acinetobacter baumannii.

关 键 词：鲍曼不动杆菌 耐药监测 多粘菌素B 

分 类 号：R515.9[医药卫生—内科学]