2006—2011年我院鲍曼不动杆菌耐药性分析  

Analysis of drug resistance of Acinetobacter baumannii in our hospital from 2006 to 2011

作　　者：杨政[1,2] 袁喆 杨忠民[2] 任玉涵[1] 刘婷婷[1] 赵倩[1] 

机构地区：[1]重庆医科大学附属第一医院感染科重庆市传染病寄生虫病学重点实验室,重庆400016 [2]荆州市中心医院感染科,湖北荆州434020

出　　处：《中国新药与临床杂志》2013年第7期585-589,共5页Chinese Journal of New Drugs and Clinical Remedies

基　　金：重庆市自然科学基金(CSTC2009BB5061);人事部科研基金(09958013)

摘　　要：目的了解我院临床分离的鲍曼不动杆菌对常用抗菌药物的耐药性变化，为临床合理使用抗菌药物提供依据。方法检测我院2006年1月-2011年12月住院患者分离的鲍曼不动杆菌六年来的耐药率和检出率，药敏试验采用纸片扩散法，以CLSI2010年标准判断分离株的敏感性，采用WHONET5．4及SPSS18．0统计软件分析数据。结果六年来我院共分离出鲍曼不动杆菌1471株，其中多重耐药、泛耐药、耐碳青霉烯类鲍曼不动杆菌分别占70．43％、17．13％、51．59％，且检出率呈逐年上升趋势。我院分离的鲍曼不动杆菌对氨苄西林-舒巴坦、头孢哌酮-舒巴坦的耐药率均于2008年最低（分别为44．6％和4．0％），2011年分别上升至64．1％和50．6％；对亚胺培南的耐药率从2007的6．5％上升至2011年的62．8％：对美罗培南的耐药率由2007年的7．2％上升至2009年的55.3％；对阿米卡星的耐药率以2009年最低（34．9％），其余每年波动于42．0％～72．7％；对庆大霉素、头孢噻肟、头孢他啶、头孢吡肟、环丙沙星、哌拉西林、哌拉西林一三唑巴坦的耐药率在2007年最低，其余每年均波动于61．9％～87．6％。结论我院鲍曼不动杆菌的耐药情况近年来十分严峻，尤其是多重耐药株、泛耐药株的大量出现应引起高度关注，以减少耐药菌株的产生和扩散。AIM To investigate the drug resistance change of clinical isolates ofAcinetobacter baumannii and provide a basis for the rational use of antimicrobial agents in clinical practice. METHODS Drug resistance rates and detection rates of Acinetobacter baumannii isolated from our hospital from Jan 2006 to Dec 2011 were determined. Disk diffusion test was used to study the antimicrobial susceptibility. Results were evaluated on the basis of CLSI 2010. WHONET 5.4 and SPSS18.0 softwares were used to analyze the data. RESULTS During the past 6 years, a total of 1 471 strains of Aeinetobaeter baumannii were isolated from our hospital, of which the detection rate of multiple drugresistance, pandrug resistance and carbapenem- resistant antibaeterials accounted for 70.43% , 17.13% and 51.59%, respectively with a annual increasing tendency. The drug resistance rate of A cinetob acter b aumannii to ampicillin- sulbactam （44.6%） and cefoperazone- shubatam （4.0%） was lowest in 2008 and increased to 64.1% and 50.6% respectively in 2011. The drug resistance rate to imipenem increased from 6.5% in 2007 to 62.8% in 2011 and the drug resistance rate to meropenem increased from 7.2% in 2007 to 55.3% in 2009. The drug resistance rate to amikacin was lowest in 2009 （34.9%） and waved from 42.0% to 72.7% in other years. The drug resistance rates to gentamicin, cefotaxime, ceftazidim, cefepime, ciprofloxacin, piperacillin, and piperacillin-tazobactam were lowest in 2007 and waved from 61.9% to 87.6% in other years. CONCLUSION The drug resistance of A cinetobacter baumannii was quite severe in our hospital in recent years. The great importance should be attached to the emergence of abundant multiple drugresistance and pan-drug resistance A cinetobacter baumannii, so as to reduce the emergence and spread of drugresistant strains.

关 键 词：鲍曼不动杆菌 抗药性 多药 抗药性 细菌 

分 类 号：R978.1[医药卫生—药品]