鲍氏不动杆菌临床分离株分布及耐药性分析  

Distribution and drug resistance of clinical isolates of Acinetobacter baumannii

作　　者：刘心[1] 杨惠芬[2] 王悦[2] 黎云燕[1] 王国栋[1,3] 

机构地区：[1]天津医科大学第二医院药学部,天津300211 [2]天津医科大学第二医院感染内科,天津300211 [3]天津医科大学基础医学院药理学系,天津300070

出　　处：《中华医院感染学杂志》2014年第6期1318-1319,1322,共3页Chinese Journal of Nosocomiology

基　　金：天津市高等学校科技发展基金项目(20120131)

摘　　要：目的调查医院住院患者鲍氏不动杆菌感染部位、科室分布,并分析其对抗菌药物的耐药性,以指导临床合理用药。方法选取2012年1月-2012年12月医院感染患者送检标本,采用BACTEC9000培养系统分离培养鲍氏不动杆菌,采用K-B琼脂法进行药敏试验。结果共分离培养出鲍氏不动杆菌183株,其感染部位分布较多的为脓液46株占25.14%、血液35株占19.13%、尿液27株占14.75%及呼吸道22株占12.02%;183株鲍氏不动杆菌的临床科室分布中ICU 55株占30.05%、呼吸内科25株占25.14%、神经内科25株占13.66%、神经外科18株占9.84%、普外科13株占7.10%,中医科9株占4.92%、血液科6株占3.28%及其他科室11株占6.01%;分离培养所得的183株鲍氏不动杆菌对氨苄西林、四环素、红霉素、庆大霉素、阿莫西林、诺氟沙星、氧氟沙星、头孢克肟和头孢哌酮的耐药率较高,均>50.00%;对美罗培南、亚胺培南和替考拉宁的敏感性较高,>80.00%。结论医护工作人员首先应采取措施控制医院鲍氏不动杆菌的感染,若感染发生,及时进行药敏试验,选择敏感性高的抗菌药物进行及时有效的治疗。OBJECTIVE To investigate the infections sites and departments distribution of Acinetobacter baumannii and analyze the drug resistance to provide basis for the reasonable use of antibiotics. METHODS From Jan 2012 to Dec 2012, the submitted specimens from the patients with nosoeornial infections were enrolled in the study, then the isolation and culture of the A. baumannii strains were performed with the BACTEC culture system, and the drug susceptibility testing was carried out by using K-B method. RESULTS A total of 183 strains of A. baumannii have been isolated, among which 46 （25.14%） strains were isolated from pus, 35 （19.13%） strains from blood, 27 （14.75%） strains from urine, 22 （12.02%） strains from respiratory tract. Of the 183 strains of A. baumannil, 55 （30.05%） were isolated from ICU, 25 （25.14%） from department of respiratory medicine, 25 （13.66%） from department of neurology, 18 （9.84%） strains from department of neurosurgery, 13 （7.10%） strains from department of general surgery, 9 （4.92 %） strains from department of traditional Chinese Medicine, 6 （3.28 %） strains from department of hematology, 11 （6.01 %） strains from other departments. The drug resistance rates to ampicillin, tetracycline, erythromycin, gentamicin; amoxicillin, norfloxacin, levofloxacin, cefixime, and cefopera- zone were more than 50.00;. The drug susceptibility rates to meropenem, imipenem, and teicoplanin were more than 80.00%. CONCLUSION It is necessary for the medical staff to take measures for control of A. baumannii infection. Once the infection occurs, the drug susceptibility testing should be performed in a timely manner, and susceptible antibiotics should be used.

关 键 词：鲍氏不动杆菌 科室 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]