2007-2011年住院患者痰标本鲍氏不动杆菌耐药变迁分析  

Change of antimicrobial resistance of Acinetobacter baumannii from sputum specimens obtained from hospitalized patients during 2007-2011

作　　者：汪涓[1] 柳爱青 姚彬[1,3] 张委[2] 

机构地区：[1]北京市海淀医院医院感染管理办公室,北京100080 [2]北京市海淀医院医院检验科,北京100080 [3]北京市海淀医院医院综合内科,北京100080

出　　处：《中华医院感染学杂志》2013年第19期4797-4798,共2页Chinese Journal of Nosocomiology

基　　金：北京市海淀区科技项目(K20110067)

摘　　要：目的调查2007—2011年住院患者痰标本鲍氏不动杆菌的耐药率变化，分析医院抗菌药物的耐药趋势，为临床提供合理用药依据。方法采用回顾性分析法，痰标本的分离与药敏试验按《全国检验技术操作规程》，在全自动微生物分析仪进行。结果共分离出革兰阴性菌5284株，其中铜绿假单胞菌1801株、鲍氏不动杆菌890株、肺炎克雷伯菌713株，分离率分别为34．0％、16．8％、13．5％；5年鲍氏不动杆菌的分离率分别为26．9％、17．9％、15．9％、13．9％、15．3％；对阿米卡星耐药率2007—2010年为4．1％～18．3％，2011年升至51．5％；头孢哌酮／舒巴坦耐药率2007—2010年为4．9％～16．1％，2011年降至1．3％，碳青霉烯类在内的其余抗假单胞菌药物的耐药率均〉60．0％。结论鲍氏不动杆菌的耐药形势严峻，阿米卡星耐药率已〉50．0％，仅头孢哌酮／舒巴蛆可用，麻引起临床高度关注。OBJECTIVE To investigate the change of drug resistance rate of the Acinetobacter baumannii （ABA） isolated from the sputum specimens of the hospitalized patients from 2007 to 2011 and analyze the trend of drug resistance so as to guide the reasonable clinical use of antibiotics. METHODS By means of retrospective analysis, the isolation of sputum specimens and the drug susceptibility testing were performed through the automatic microbial analyzer by referring to the National Operation guidelines for Clinical Techniques. RESULTS A total of 5284 strains of gram-negative bacteria were isolated , among which there were 1801 （34.0%） strains of Pseud- omonas aeruginosa, 713 （13.5%） strains of Klebsiella pneumoniae, and 890 （16. 8%） strains of Acinetobacter baumannii ; the isolation rates of the A. baumannii during the past fives were 26.9%, 17.9%, 15.9%, 13.9%, and 15.3%, respectively, the drug resistance rate to amikacin ranged between 4.1% and 18.3% during 2007-- 2010, increasing to 51. 5% in 2011; the drug resistance rate to cefoperazone/sulbactam varied from 4. 9%to 16.1% during 2007- 2010 and dropped to 1. 3% in 2011; the drug resistance rate to the remaining antipseudomonal antibiotics including carbapenems was more than 60. 0%. CONCLUSION The situation of the drug resistance of the A. baumannii is severe, and the drug resistance rate to amikacin is more than 50.0~. Only cefoperazone sulbactam can be used; it is necessary to attach great importance in the hospital.

关 键 词：鲍氏不动杆菌 分布 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]