2013年某教学医院鲍曼不动杆菌临床分布及耐药性分析  

Clinical distribution and drug resistance analysis among Acinetobacter baumannii isolated from a university-affiliated hospital in 2013

作　　者：蔡瑜[1] 梅亚宁[2] 文怡[2] 刘根焰[2] 陈友华[2] 夏文颖[2] 徐婷[2] 顾兵[2] 

机构地区：[1]安徽省合肥市第一人民医院检验科,合肥市230061 [2]南京医科大学第一附属医院检验学部.国家临床检验重点专科

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第4期64-67,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金(No.81000754)

摘　　要：目的了解2013年某院感染鲍曼不动杆菌临床分布及耐药性情况,为临床合理应用抗菌药物提供依据。方法对2013年1月至12月临床送检的痰、血液和尿液等标本进行细菌培养、分离与鉴定并进行抗菌药物敏感试验。采用VITEK-2 Compact全自动微生物鉴定系统或API细菌鉴定板条进行菌种鉴定。采用纸片琼脂扩散法(Kirby-Bauer法,KB法)进行药敏试验。采用WHONET 5.6软件进行数据分析。结果 2013年共分离1 417株鲍曼不动杆菌,呼吸道标本中所占比例最高,达到86.4%。临床分布以外科最多(28.2%,399/1 417),其次是老年科(25.7%,364/1 417)与监护病房(24.1%,341/1 417)。2013年该菌株对临床常用抗菌药物高度耐药,除了米诺环素与阿米卡星外,其他药物耐药率均在65%以上。碳青霉烯类药物亚胺培南、美洛培南耐药率高达80.7%和81.9%。结论鲍曼不动杆菌在本院耐药率较高,应加强抗菌药物的合理使用,并建立切实有效的感染控制措施,阻断多重耐药菌的传播。Objective To investigate the clinical distribution and drug resistance of Acinetobacter baumanni （A. baumannii） in 2013 and to provide basis of rational use of antibiotics for the clinical departments. Methods The bacteria were isolated from specimens by conventional bacterial culture, which were identiifed by the VITEK-2 Compact fully automatic microorganism analyzer or API bacterial identiifcation strip. Antimicrobial susceptibility test were carried out by the disc diffusion method （Kirby-Bauer method）. Data analyses were performed by Whonet 5.6 software. Results A. baumannii ranked the highest proportion （86.4%, 1 224/1 417） in respiratory tract samples. The highest three places of samples separation of A. baumannii positive were surgical department （accounted for 28.2%）, department of geriatrics （accounted for 25.7%） and intensive care unit （accounted for 26.4%）. The clinical strains were highly resistant to commonly used antibiotics. Most resistance rates of A. baumannii were more than 65%, except minocycline and amikacin. The resistance rates against imipenem and meropenem were highly as 80.7%and 81.9%, respectively. Conclusions Drug-resistance of A. baumanniiin the hospital was relatively serious. Therefore, the interventional infection control measures should be strengthened to prevent the spread of multi-drug resistant microorganisms.

关 键 词：鲍曼不动杆菌 耐药性 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]