鲍氏不动杆菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of Acinetobacter baumannii

作　　者：胡蓉蓉[1] 马小琴[1] 张能华[1] 王静[2] 

机构地区：[1]浙江中医药大学附属嘉兴中医院检验科,浙江嘉兴314001 [2]浙江医学高等专科学校,浙江杭州310053

出　　处：《中华医院感染学杂志》2014年第7期1577-1579,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科学研究基金项目(2010KYA009)

摘　　要：目的了解鲍氏不动杆菌在临床的分离率和病区分布及耐药性变迁,为临床合理用药提供参考依据。方法收集2008-2012年医院住院患者临床标本分离出的2 412株鲍氏不动杆菌,了解其分布特点及耐药性,采用K-B法进行药敏试验,结果判定参照美国临床实验室标准化委员会2010年版标准,采用WHONET 5.4和EXCEL软件分析细菌分布和耐药性。结果 2 412株鲍氏不动杆菌81.50%检自于痰标本,77.10%的标本来自ICU;2008年分离率为5.13%,到2012年分离率增加至9.91%,该菌的分离率呈上升趋势;鲍氏不动杆菌对氨曲南、环丙沙星耐药率>90.00%,对亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药率从2008年13.9%、11.5%、8.6%升至2012年的55.3%、51.6%、48.3%,其对临床16种抗菌药物的耐药性呈逐年上升趋势,部分表现出多药耐药性。结论鲍氏不动杆菌的耐药状况日益严重,应加强对多药耐药菌的监测和管理,合理使用抗菌药物,严格消毒隔离制度,防止医院感染,避免不必要的侵入性操作,提高患者免疫力,防止鲍氏不动杆菌的医院感染及暴发流行。OBJECTIVE To understand the separation rate and area distribution and drug resistance changing of A cinetobacter baumani in in clinics ,so as to provide the basis for clinical rational drug use .METHODS A total of 2412 strains of A .baumani from inpatients clinical samples during 2008 to 2012 were collected ,to understand the distribution and drug resistance of it .The susceptibility test was performed by K-B method .The interpretation of the results was based on the CLSI 2010 .WHONET 5 .4 and EXcellsoftware were used for bacterial distribution and drug resistance analysis .RESULTS Among 2412 strains of A .baumannii ,81 .50% were from sputum speci-mens ,77 .10% specimens from patients in ICU ward .Separation rate in 2008 was 5 .13% and increased by 9 .91%in 2012 ,which was on the rise .The resistance rate of A .baumani to aztreonam and ciprofloxacin was higher than 90% .The drug resistance respectively to imipenem , meropenem and cefoperazone/sulbactam was also from 13 .9% and 8 .6% in 2008 to 51 .6% ,55 .3% and 48 .3% .The drug resistance of A .baumannii to 16 kinds of an-timicrobial drugs was in a rising trend year by year ,and part shows the characteristics of multiple drug resistance . CONCLUSION The situation of drug resistance of Acinetobacter baumannii is becoming more and more serious , the monitoring and management of multi-drug resistant bacteria should be strengthened ,also rational use of antibi-otics ,stricting disinfection and quarantine system need to obey to prevent hospital infections ,avoid unnecessary invasive operation ,improve the immune system ,and prevent A cinetobacter baumannii nosocomial infection and outbreak .

关 键 词：鲍氏不动杆 感染 耐药性 

分 类 号：R378[医药卫生—病原生物学]