耐碳青霉烯类抗生素鲍曼不动杆菌的耐药谱分析  

Antibiotics Resistance Profiles of Carbapenem-Resistant Acinetobacter Baumannii Isolates

作　　者：郭洁[1] 徐杰[2,3] 王丽丽[2] 王玉飞[2] 苑锡铜[2] 袁静[2] 宋宏彬[2] 黄留玉[2] 张宁[1] 陈泽良[2] 陈永德[1] 刘世巍[1] 

机构地区：[1]中国中医研究院望京医院,北京100120 [2]军事医学科学院疾病预防控制所,北京100071 [3]吉林大学公共卫生学院医学基因组学研究中心,长春130021

出　　处：《现代检验医学杂志》2012年第1期107-109,共3页Journal of Modern Laboratory Medicine

摘　　要：目的了解耐碳青霉烯抗生素鲍曼不动杆菌的抗生素耐药情况，指导临床合理用药。方法选取中国中医研究院望京医院2008-2010年期间临床和门诊患者样本的耐碳青霉烯抗生素的鲍曼不动杆菌分离株，通过药敏实验分析这些菌株时15种常见抗生素的耐药性。结果从标本类型分布看，最主要的是痰液标本，共110株（88％），其次是分泌物共9株（7．2％）和2株自导管（1．6％）。从科室统计分析发现，ICU分离到的鲍曼不动杆菌数最多，68株；其次是针灸科，分离的菌株是15株；神经外科、CCU、普通外科、心内科、内分泌科、呼吸科、创伤一科，分别分离到14，11，7，4，3，2和1株。选取的125株鲍曼不动杆菌对哌拉西林、美罗培南、替卡西林／克拉维酸、哌拉西林／三唑巴坦、环丙沙星、亚胺培南、头孢吡肟、阿米卡星、妥布霉素、头孢曲松和头孢他啶耐药率高达90％以上，依次为100％。99．2％，99．2％，98．4％，96．8％，96％，96％，94．4％，93．6％，92％和91．2％。其次是氨曲南、左氧氟沙星和头孢哌酮／舒巴克坦，耐药率依次是72．8％，64％和30．4％，对多黏菌素B的耐药率最低，仅为0．8％。结论该院耐碳青霉烯抗生素的鲍曼不动杆菌对大多数种类的抗生素均有较高的耐药性，仅对少数几种抗生素表现为敏感，临床上应严格按照科学的用药方案进行抗生素使用，防治耐药性的进一步产生和院内传播。Objective To determine the antibiotic resistance profiles of Acinetobacter baurnannii and direct clinical antibiotics use, Methods Carbapenem-resistant Acinetobacterbaumannii isolates of Wangjing Hospital of China Academy of TCM during 2008 to 2010 were selected for sensitivity to 15 antibiotics. Results A total of 125 carbapenem-resistant isolates were analyzed for their antibiotics resistance. The resistance percent for piperacillin,meropenem, ticareillin/clavulanic acid, piperacillin/tazobactam, ciprofloxacin, irnipenem, cefepime, amikacin, tobramycin, ceftriaxone and ceftazidime were 100%, 99.2%,99.2%,98. 4%,96.8%,96%,96% ,94.4%,93.6% ,92% and 91.2%, respectively. Resistance percent to all these antibiotics was higher than 90%. Resistance percent to aztreonam, levofloxacin and cefoperazone/Shubaketan were 72. 8%, 64 % and 30. 4 %, respectively. The most sensitive antibiotics was polymyxin B,whose resistance was only 0. 8 % Conclusion Carbapenem antibiotic-resistant Aclnetobacter baurnannii were resistant to most types of antibiotics, and remains sensitivity to only a few antibiotics. Strict adherence to the controlled clinical use of antibiotics is the most important means to prevent emergence and spread of resistance in hospitals.

关 键 词：鲍曼不动杆菌 耐药谱 临床用药 

分 类 号：R378[医药卫生—病原生物学] R446.5[医药卫生—基础医学]