泛耐药鲍曼不动杆菌医院感染的耐药性分析  

Drug resistance analysis of pan-drug-resistant Acinetobacter baumannii in hospital

作　　者：孙成栋[1] 李真[1] 刘斯 王燕[1] 

机构地区：[1]北京积水潭医院感染疾病科,100035 [2]天津红日药业

出　　处：《中华危重病急救医学》2013年第6期369-372,共4页Chinese Critical Care Medicine

摘　　要：目的了解泛耐药鲍曼不动杆菌医院感染现状及其对临床常用抗菌药物的耐药情况，为合理应用抗菌药物提供依据。方法收集本院2009年1月至2012年12月住院患者的各类微生物检测标本，对标本进行细菌培养和分离。采用VITEK2-Compact全自动微生物分析仪进行鉴定和药敏分析。结果4年共分离出307株泛耐药鲍曼不动杆菌，主要来源为呼吸道分泌物（69．4％），其次为创面分泌物（14．7％）；以重症监护病房（ICU，占26．4％）、呼吸科（占26．1％）、老年病科（占23．1％）的检出率最高；对临床常用抗菌药物几乎完全耐药，头孢噻肟、哌拉西林、美罗培南、亚胺培南、环丙沙星、四环素等药物的耐药率可高达100％，除了头孢哌酮／舒巴坦与多黏菌素外，其他药物的耐药率均在90％以上；即使是头孢哌酮／舒巴坦在本院的泛耐药鲍曼不动杆菌中也有近约30％的耐药率，但对多黏菌素的耐药率为0。结论泛耐药鲍曼不动杆菌对多数临床常用抗菌药物表现为耐药，根据药敏结果选用抗菌药物，针对泛耐药鲍曼不动杆菌的感染可选用多黏菌素与头孢哌酮／舒巴坦或者含舒巴坦制剂的药物。Objective To investigate current situation of pan-drug-resistant Acinetobacter baumannii in hospital and its drug-resistance , then provide reference for rational use of antibiotics in clinic. Methods All kinds of microbial test specimens from January 2009 to December 2012 of hospitalized patients were cultured and separated. VITEK 2-Compact fully automatic microorganism analyzer was used to identify and analyze drug sensitivity. Results Three hundred and seven strains pan-drug-resistant Acinetobacter baumannff were isolated in 4 years, the primarily source were sputum, accounted for 69.4%, followed by the wound secretion 14.7%. The highest three places of samples separation of extensive drug-resistant Acinetobacter baumannii positive was intensive care unit （ICU, accounted for 26.4% ）, department of respiratory medicine （accounted for 26.1% ） and department of geriatrics （accounted for 23.1% ）. Extensive drug-resistant Acinetobaeter baujannii almost completely resisted to clinical commonly used antimicrobial agents, drug resistant rate could he as high as 100% such as cefotaxime, meropenem, piperacillin, imipenem, ciprofloxacin, and tetracycline except for cefoperazone-sulbactam and polymyxin, and the rate of other drugs were all above 90%. Drug-resistant of cefoperazone-sulbactam was nearly 30% in our hospital, and sensitive rate was 100% to polymyxin. Conclusions Pan-drug-resistant Acinetobacter baumannii is resistant for most clinical commonly used antimicrobial drug, antimicrobial agents were chosen according to drug susceptibility testing. Antibacterial drugs such as polymyxin and cefoperazone-sulbactam or sulbactam contained drugs can be selected for pan-drug-resistant.

关 键 词：泛耐药鲍曼不动杆菌 医院感染 抗菌药物 耐药性 

分 类 号：R446[医药卫生—诊断学]