呼吸系统鲍曼不动杆菌的感染现况及耐药性分析  

Acinetobacter baumannii infection and drug susceptibility of the respiratory system

作　　者：黄健云[1] 芮勇宇[2] 莫和国[1] 黎泳仪 陆小琴[1] 欧水连[1] 邴晏如[1] 

机构地区：[1]南方医科大学附属小榄医院检验科,广东中山528415 [2]南方医科大学南方医院检验科,广东广州510515

出　　处：《现代预防医学》2015年第11期2057-2059,共3页Modern Preventive Medicine

基　　金：中山市医学科研基金项目(2009063)

摘　　要：目的了解基层医院患者呼吸系统鲍曼不动杆菌的感染现况和评价《抗菌药物临床应用专项整治活动方案》的实施效果,为临床医生合理应用抗菌药物提供科学依据。方法用VITEK2微生物分析系统对本院2012年1月-2013年12月呼吸系统标本中分离的鲍曼不动杆菌进行药敏分析,比较分析《抗菌药物临床应用专项整治活动方案》干预前(2012年)和干预后(2013年)呼吸系统鲍曼不动杆菌的耐药性。结果 2012年(干预前)和2013年(干预后)从本院呼吸系统标本分离的鲍曼不动杆菌分别为225株和153株,其主要分布于ICU,分别占29.8%和31.4%,其次是呼吸内科,分别占16.0%和18.3%。该项方案干预后,多重耐药鲍曼不动杆菌的检出率由39.6%降为35.3%,其对头孢曲松、头孢他啶、头孢吡肟、庆大霉素、复方新诺明、环丙沙星、左旋氧氟沙星和妥布霉素的耐药率显著降低(χ2>3.84,P<0.05)。结论该项方案干预后,呼吸系统标本分离的鲍曼不动杆菌对常用14种抗菌药物的耐药率低于干预前,其中有8种抗菌药物的耐药率显著降低。Objective To investigate the current situation on the infection of Acinetobacter baumannii in respiratory system and evaluate the efficiency of drug resistance, which may provide scientific basis for rational antibiotics use. Methods VITEK-2 microbiology analysis system was adopted to the pathogen identification and drug sensitivity. Drug resistances were contrasted before and after the project execution. Results 225 strains and 153strains Acinetobacter baumannii were isolated from the respiratory system in 2012 and 2013, which mainly distributed in ICU accounting for 29.8% and 31.4%, respectively. Secondly, 16.0% and 18.3% of those were isolated from the department of respiratory medicine in 2012 and 2013. The infection rate of multi-resistant Acinetobacter baumannii decreased from 39.6% to 35.3%, and the resistance rates of cefatriaxone, ceftazidime, cefepime, gentamicin, cotrimoxazole, ciprofloxacin, levofloxacin, and tobramycin decreased significantly after the implementation of drug resistance control management （x2〉3.84,P〈0.05）. Conclusion The drug resistance rates of Acinetobacter banmannii to 14 kinds of routine antibacterial drugs in 2013 are lower than those in 2012 from the respiratory system. Among them, the drug resistance rates of Acinetobacter baumannii to 8 kinds of antibacterial drugs significantly decreased.

关 键 词：鲍曼不动杆菌 抗药性 细菌 多重耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]