医院2012-2014年鲍曼不动杆菌耐药性监测分析  

Analysis of drug resistance to acinetobacter baumannii from 2012 to 2014

作　　者：武芳[1] 张叶毛[2] 赵建平 周秀岚[3] 

机构地区：[1]内蒙古医科大学附属医院消化科,呼和浩特010050 [2]内蒙古医科大学附属医院感染科,呼和浩特010050 [3]内蒙古医科大学附属医院药剂部,呼和浩特010050 [4]内蒙古自治区人民医院检验科

出　　处：《中国医药》2015年第10期1537-1541,共5页China Medicine

基　　金：内蒙古自治区自然科学基金（2013MS11113）

摘　　要：目的 对2012-2014年鲍曼不动杆菌（AB）的分离情况及耐药性变迁进行分析,指导临床合理用药.方法 回顾性分析2012年1月至2014年12月自内蒙古自治区人民医院分离出的738株AB的标本来源、病区分布和耐药性;对比分析耐亚胺培南AB （1RAB）和亚胺培南敏感AB（ISAB）的耐药性差异.结果 AB的病区来源主要为重症监护病房（ICU）[48.4％（357/738）]和神经内科[13.0％ （96/738）];全院IRAB的检出率为79.3％（585/738）,其中ICU的检出率高达96.6％（345/357）.AB和IRAB的标本来源主要为痰液,分别占80.5％（594/738）和82.1％ （480/585）.AB除对阿米卡星27.4％ （202/738）和复方新诺明39.0％（288/738）的耐药率较低外;对其他11种抗菌药物的耐药率均较高,其中对哌拉西林钠他唑巴坦钠、盐酸头孢吡肟和亚胺培南的耐药率分别为77.8％（574/738）、81.7％（603/738）和79.3％（585/738）;2012、2013和2014年对复方新诺明的耐药率分别为68.2％（148/217）、27.1％（73/269）和26.6％（67/252）,呈逐年递减趋势.IRAB对阿米卡星和复方新诺明的耐药率为29.6％（173/585）和42.9％ （251/585）,对其他10种抗菌药物的耐药率达91.6％ ～ 100.0％;ISAB对哌拉西林钠他唑巴坦钠和阿米卡星的耐药率较低,分别为3.3％（5/153）和6.5％ （10/153）,对其他10种抗菌药物的耐药率为12.4％ ～ 25.5％,相对也较低.ISAB对12种抗菌药物的耐药率均明显低于IRAB,差异有统计学意义（P＜0.05）.结论 内蒙古自治区人民医院AB和IRAB的分离率和耐药性较高;AB对复方新诺明的耐药率呈逐年递减趋势.Objective To analyze the isolation condition and variation of drug resistance to acinetobacter baumannii （AB） from 2012 to 2014.Methods Totally 738 strains of AB and 585 strains of imipenem resistant AB （IRAB） isolated from January 2012 to December 2012 were retrospectively analyzed.The source of samples,ward distribution and drug resistance were collected.The difference of drug resistance between IRAB and imipenem sensitive AB （ISAB） were compared.Results The main wards of AB were intensive care unit （ICI） [48.4% （357/738）] and department of neurology [13.0% （96/738）].The total detection rate of IRAB was 79.3% （585/738）,and the detection rate of IRAB in ICU was up to 96.6% （345/357）.The source of samples was sputum for both AB and IRAB [80.5% （594/738） and 82.1% （480/585）,respectively].The resistance rate of AB to amikacin was relatively low,being 27.4% （202/738）;the resistance rates to the other 11 kinds of antibiotics were high,for example,was 77.8% （574/738） to piperacillin tazobactam,was 81.7% （603/738） to cefepime and was 79.3% （585/738） to imipenem;the resistance rate of AB to compound sulfamethoxazole was gradually decrease year by year [2012：68.2% （148/217）,2013：27.1% （73/269）,2014：26.6% （67/252）].The resistance rates of IRAB to amikacin and compound sulfamethoxazole were 29.6% （173/585） and 42.9% （251/585）,the resistance rates to the other 10 kinds of antibiotics were up to 91.6%-100.0%.The resistance rates of ISAB to piperacillin tazobactam and amikacin were low,being 3.3% （5/153） and 6.5% （10/153）,the resistance rates to the other 10 kinds of antibiotics were also low,being 12.4%-25.5%.The resistance rates of ISAB to 12 kinds of antibiotics were all significantly lower than those of IRAB （P 〈 0.05）.Conclusions The isolation rate and resistance rate of AB and IRAB are high;the drug resistance rate of AB to compound sulfamethoxazole is decreased year by year.

关 键 词：鲍曼不动杆菌 亚胺培南 多药耐药 

分 类 号：R373.1[医药卫生—病原生物学]