鲍氏不动杆菌临床分离株的耐药性变迁  

Change of antimicrobial resistance of clinical isolates of Acinetobacter baumannii

作　　者：王军[1] 余清源 刘华[1] 瞿秀[1] 

机构地区：[1]利川市人民医院检验科,湖北利川445400

出　　处：《中华医院感染学杂志》2014年第18期4429-4431,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(WJ01564)

摘　　要：目的：探讨2010-2012年山区医院临床分离的鲍氏不动杆菌（ABA ）耐药性变迁，为临床选择抗菌药物提供实验室参考依据。方法对医院2010-2012年分离的353株ABA耐药性进行了回顾性调查分析；ABA分离培养严格按《全国临床检验操作规程》进行；采用法国生物梅里埃公司VITEK-32全自动微生物分析仪和配套鉴定试剂盒进行菌种鉴定；采用CLSI推荐的纸片扩散法（K-B法）进行药敏试验，并依据CLSI标准判读药敏结果，应用WHONET 5．5软件进行数据处理。结果医院ABA在呼吸道标本中检出率最高，占67．1％，其次是脓性分泌物和尿液，分别占11．1％和9．1％；ABA对临床常用抗菌药物的耐药性呈逐年升高趋势，对阿米卡星、亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率在12．6％～20．6％；2010-2012年泛耐药ABA检出率分别为12．6％、14．4％、16．3％；耐亚胺培南ABA检出率分别为14．9％、17．6％、17．7％。结论医院鲍氏不动杆菌的耐药性总体呈逐年上升态势，应严格执行卫生部《抗菌药物临床应用管理办法》，将ABA列入医院监控的重点菌株，实行医院细菌耐药性预警公示制度，扭转山区医院细菌耐药性上升的不良现状。OBJECTIVE To approach the change of drug resistance of clinical isolates of A cinetobacter baumannii in mountain area so as to provide laboratory basis for clinical use of antibiotics .METHODS The drug resistance of 353 strains of A .baumannii isolated from 2010 to 2012 was retrospectively investigated ,then the isolation and culture of the A .baumannii strains were carried out by referring to National Guide to Clinical Laboratory Operation Proce-dures ,the strains were identified by using VITEK-32 automatic microorganism analyzer of BioM＆#233;rieux ,France and matched identification detergent kit ,the drug susceptibility testing was performed by means of the disk diffu-sion method （K -B method） recommended by CLSI ,the results of the drug susceptibility testing were interpreted in accordance with CLSI ,and the data were statistically analyzed with the use of WHONET 5 .5 software . RESULTS Among the isolated A .baumannii strains ,67 .1% were isolated from respiratory tract specimens , 11 .1% from purulent secretions ,9 .1% from urine .The drug resistance of the A .baumannii strains to the com-monly used antibiotics showed an upward trend ,and the drug resistance rates to amikacin ,imipenem ,meropen-em ,cefoperazone-sulbactam ,and piperacillin-tazobactam varied from 12 .6% to 20 .6% .The isolation rate of pan-drug-resistant A .baumannii was 12 .6% in 2010 ,14 .4% in 2011 ,16 .3% in 2012 .The isolation rate of imipenem-resistant A .baumannii was 14 .9% in 2010 ,17 .6% in 2011 ,17 .7% in 2012 .CONCLUSION The drug resistance of the A .baumannii strains shows an upward trend .It is necessary to strictly implement the measures of manage-ment of clinical use of antibiotics ,focus on the monitoring of the A .baumannii strains ,and develop warning mech-anism of bacterial drug resistance so as to restrain rapidly increasing adverse trends of bacterial resistance in the mountain area hospitals .

关 键 词：鲍氏不动杆菌 耐药性 变迁 

分 类 号：R378[医药卫生—病原生物学]