连续11年深圳地区鲍曼不动杆菌感染的临床分布及耐药趋势分析  

Clinical distribution and trend of drug resistance of Acinetobacter baumannii causing infections in consecutive 11 years in Shenzhen

作　　者：李文青[1,2] 吴伟元[1,2] 卢月梅 吴劲松[1,2] 程锦娥 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院检验科,广东深圳518020

出　　处：《中国微生态学杂志》2013年第6期667-670,共4页Chinese Journal of Microecology

基　　金：深圳市科技计划项目(201103336)

摘　　要：目的了解医院鲍曼不动杆菌的耐药性变迁和临床分布特点,为合理应用抗菌药物和预防控制医院感染提供依据。方法回顾性分析2001年1月到2011年12月临床标本中分离的1 613株鲍曼不动杆菌资料;用WHONET 5.4分析鲍曼不动杆菌的分离率和耐药率变迁。结果鲍曼不动杆菌感染主要发生在ICU和呼吸内科,分别占43.89%和24.49%;痰标本所占比例最高(70.30%)。鲍曼不动杆菌、多药耐药鲍曼不动杆菌的分离率及对临床常用的15种抗菌药物耐药率总体呈上升趋势;并且2009年呈飞跃式上升且2010和2011年居高不下,2011年分离出泛耐药鲍曼不动杆菌,分离率高达57.55%。临床常用药氨苄西林/舒巴坦、头孢哌酮/舒巴坦和米诺环素近三年的耐药率和中介率也明显升高。结论鲍曼不动杆菌的耐药形势严峻,多药耐药鲍曼不动杆菌和泛耐药鲍曼不动杆菌比例明显增加,重症监护病房和呼吸科是预防控制的重点科室。Objective To understand the distribution characteristics and drug resistance of Acinetobacter baumannii,so as to provide reference for rational use of antibiotics and infection control.Methods The results of drug susceptibility and clinical distribution of Acinetobacter baumannii from Jan 2001 to Dec 2011 in Shenzhen People′s Hospital were retrospectively analyzed.The variations of isolation rate and resistance rate were analyzed by WHONET 5.4.Results Acinetobacter baumannii infections were mainly distributed at ICU wards and respiratory wards,accounting for 43.89% and 24.49% respectively;Most strains were isolated from sputum specimens（70.30%）.The isolation rates of Acinetobacter baumannii and multi-drug resistant strains showed an increasing trend,so did the resistance rates of Acinetobacter baumannii to 15 commonly used antibacterial drugs,which increased sharply in 2009 and remained high in 2010 and 2011.Pan-drue resistant strains appeared in 2011,and the isolation rate was 57.55%.The resistance rate and medium rate of Acinetobacter baumannii to Ampicillin-Sulbactam,Cefperazone-Sulbactam and Minocycline also increased obviously in last three years.Conclusion The drug resistance of Acinetobacter baumannii is severe;the isolation rates of multi-drug and pan-drug resistant Acinetobacter baumannii are increasing sharply.Infection control should be enhanced in ICU and respiratory department.

关 键 词：鲍曼不动杆菌 抗菌药物 耐药性 临床分布 

分 类 号：R378[医药卫生—病原生物学]