鲍氏不动杆菌耐药性分析  

Drug resistance of Acinetobacter baumannii and its clinical significance

作　　者：孙成栋[1] 李真[2] 付书情[1] 刘颖[3] 

机构地区：[1]北京积水潭医院感染疾病科,北京100035 [2]北京积水潭医院感感染疾病科,北京100035 [3]北京积水潭医院检验科,北京100035

出　　处：《中华医院感染学杂志》2013年第13期3252-3254,共3页Chinese Journal of Nosocomiology

基　　金：北京市科技重大项目(京科技发[2002]641)

摘　　要：目的了解鲍氏不动杆菌感染现状及其对临床常用抗菌药物的耐药性,为临床合理应用抗菌药物提供依据。方法对医院2011年6月-2012年6月住院患者的各类微生物检测标本进行病原菌培养和分离,采用VITEK-2Compact全自动微生物分析仪进行鉴定和药敏分析。结果从各种临床标本中共分离出158株鲍氏不动杆菌,主要来源为呼吸道分泌物占76.58%,其次为伤口分泌物占13.29%,鲍氏不动杆菌的科室分布以外科ICU、干部科、呼吸内科为主,分别占27.85%、14.56%、10.76%;鲍氏不动杆菌对常用抗菌药物均产生了较严重的耐药性,除对头孢哌酮/舒巴坦耐药率为31.6%外,对其他药物的耐药率在53.8%～90.5%;158株鲍氏不动杆菌中分离出89株泛耐药不动杆菌,占56.33%,对多黏菌素E敏感率达100.0%,对头孢哌酮/舒巴坦耐药率为53.6%。结论鲍氏不动杆菌对常用抗菌药物均耐药严重,应根据药敏结果选用抗菌药物;针对泛耐药鲍氏不动杆菌的感染可选用多黏菌素与头孢哌酮/舒巴坦或含舒巴坦制剂的药物。OBJECTIVE To investigate the present situation of Acinetobacter baumannii infections and explore the drug resistance to the commonly used antibiotics so as to provide basis for reasonable use of antibiotics.METHODS The clinical specimens obtained from the hospitalized patients between Jun 2011and Jun 2012were cultured for pathogens,then identification and the drug susceptibility testing were performed by using VITEK2Compact fully automatic microorganism analyzer.RESULTS A total of 158strains of A.baumannii were isolated from the clinical specimens,among which 76.58% were isolated from respiratory tract secretions,followed by wound secretions（13.29%）.Of all the A.baumannii isolated,27.85% were isolated from the surgical ICU,14.56%from the cadres department,and 10.76% from the respiratory internal medicine department.The A.baumannii strains have produced high drug resistance to the commonly used antibiotics;except for 31.6% to cefoperazone-sulbactam,the drug resistance of the A.baumannii strains varied between 53.8% and 90.5%.Totally 89strains of pandrug-resistant A.baumannii were isolated from the 158strains of A.baumannii,accounting for 56.33%,the drug susceptibility rate to polymyxin E was up to 100.0%,and the drug resistance rate to cefoperazone-sulbactam was 53.6%.CONCLUSIONThe A.baumannii is highly resistant to the commonly used antibiotics,it is necessary to use antibiotics based on the result of drug susceptibility testing.The polymyxin and cefoperazone-sulbactam or sulbactam-containing drugs are preferred for the treatment of pandrug-resistant A.baumannii infections.

关 键 词：鲍氏不动杆菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]