鲍曼不动杆菌感染分布及耐药性动态变迁  

Dynamic changes of drug resistance and infections distribution of Acinetobacter baumannii

作　　者：韩志伟[1] 陈科[2] 叶会明[1] 

机构地区：[1]内江市第一人民医院检验科,四川内江641000 [2]内江市第一人民医院中心ICU,四川内江641000

出　　处：《中国微生态学杂志》2010年第9期834-836,840,共4页Chinese Journal of Microecology

摘　　要：目的了解鲍曼不动杆菌对多种抗菌药物耐药性的动态变迁以及感染病例分布情况,为临床治疗鲍曼不动杆菌提供参与。方法 2007年1月至2009年12月从患者不同标本分离的鲍曼不动杆菌(ATB Expression细菌鉴定系统鉴定到种),采用CLSI/NCCLS标准K-B法对临床常用抗菌药物进行耐药性分析。结果鲍曼不动杆菌2007年至2009年检出率分别为6.5%、8.9%和17.6%;标本主要来源于痰(78.4%),病区集中于中心ICU(33.3%)、呼吸内科(22.8%)和消化内科(13.0%);该菌耐药现象严重,除亚胺培南、美罗培南和头孢哌酮/舒巴坦保持较高的敏感性,其他药物耐药性均>60%,而且耐药性逐年上升。结论鲍曼不动杆菌的耐药问题日趋严重,加强其耐药性监测可指导临床治疗,为临床提供最新的流行病学和耐药性变迁资料;泛耐药菌株感染主要发生在长期应用抗菌药物及长时间住院的患者,因而应加强医院环境和人员消毒,控制鲍曼不动杆菌在医院内的定值与播散。Objective To study the dynamic changes of drug resistance and infection distribution of Acinetobacter baumannii and provide guidance for clinical treatment.Method Acinetobacter baumammii isolates were collected in our hospital from Jan 2007 to Dec 2009.Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of CLSL/BCCKS.Result The isolating rates of Acinetobacter baumammii from 2007 to 2009 were 6.5%,8.9%,and 17.6%,respectively.The bacteria distributed mainly in ICU（33.3%）,respiratory wards（22.8%） and gastroenterology wards（13.0%）,which the main source being sputum（up to 78.4%）.More than 60% of isolates were resistant to all antimicrobial agents tested except imipenem meropenem and cefoperazone/sulbactam.Conclusion The drug resistance of Acinetobacter baumammii has become increasingly serious.The drug-resistant Acinetobacter baumammii exists most frequently in patients who received antibiotic treatment while staying in hospital for a long time.The disinfection for hospital environment and medical staff should be strengthened in order to control the distribution of Acinetobacter baumammii.

关 键 词：鲍曼不动杆菌 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]