2009～2011年铜陵地区鲍曼不动杆菌医院感染的临床分布及耐药性分析  

Analysis of Clinical Distribution and Drug Resistance of Acinetobacter Baumannii in Nosocomial Infection from 2009 to 2011 in Tongling

作　　者：唐吉斌[1] 章文[1] 胡志军[1] 翁伟[1] 

机构地区：[1]铜陵市人民医院检验科,安徽铜陵244009

出　　处：《现代检验医学杂志》2012年第6期61-63,66,共4页Journal of Modern Laboratory Medicine

摘　　要：目的了解铜陵地区部分医院近3年鲍曼不动杆菌（ABA）感染的临床分布及其耐药性的变化，为临床治疗鲍曼不动杆菌感染提供依据。方法对2009～2011年铜陵地区部分医院临床分离的鲍曼不动杆菌进行鉴定，采用纸片扩散法进行药敏试验，采用WHONET5．4软件进行统计分析鲍曼不动杆菌的病区分布情况与耐药率及变化趋势。结果3年中共分离出1024株鲍曼不动杆菌，主要分离自痰液（59．9％）。其次为咽拭子（儿．9％）和分泌物（4．3％）；科室分布以ICU（35．3％）为主，其次为脑外科（11．9％），呼吸内科（11．3％）和骨科（5．7％）；3年来鲍曼不动杆菌总体耐药率呈上升趋势，尤以亚胺培南和关罗培南最为明显，亚胺培南3年耐药率分别为29．2％，59％和87．1％，美罗培南3年耐药率分别为33．3％，61．3％和96．3％；临床常用抗茵药物中只有头孢哌酮/舒巴坦和米诺环素耐药率低于50％，其余均大于50％。结论鲍曼不动杆菌是医院感染的重要感染源，其对临床常用抗茵药物耐药性总体呈明显上升趋势，临床医师可根据耐药率，合理选择抗茵药物，控制耐药菌株的流行及医院感染。Objective To investigate the clinical distribution and the drug resistance of Acinetobacter baumannii （ABA） dur- ing past 3 years in Tongling area,and to provide evidence for clinical treatment of ABA infection. Methods The isolated of ABA strains from 2009 to 2011 in Tongling area were identified and antimicrobial susceptibility tests were performed using the K-B method, and thus, the ward distribution and the drug resistance rates and the changing trend were respectively ana- lyzed by WHONET5.4 software. Results A total of 1 024 ABA strains were isolated in 3 years,in which the most common specimens were sputum（59.9%）, followed by the throat swab（11.9%） and the secretions（4.3%）. When it came to the ward distribution, ICU was the primary, which accounted for 35.3%, followed by the department of cerebral surgery （ 11.9 % ）, the respiratory medicine （11.3 % ） and the department of orthopedics （5.7 % ）. There was a obviously increasing overall trend in drug resistance rates from 2009 to 2011, while imipenem and meropenem were especially obvious,in which the drug resistance rates of imipenem were 29.20/00,59% and 87.1% in last 3 years, and the rates of meropenem were 33.3%,61.3% and 96.3% ,respectively. The drug resistance rates of the most commonly used antibiotics were more than 50%,apart form Cefoperazone/sulbactam and Minoeycline. Conclusion The ABA is an important source of infection,which exhibited a clear and rapid upward trend in the drug resistance rates. The clinician should choose antibiotics reasonably in the light of the drug resistance rates so as to control the epidemic of the drug-resistant strains and hospital infection.

关 键 词：鲍曼不动杆菌 医院感染 耐药性 

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