2009-2014年我院临床分离鲍曼不动杆菌的分布及耐药性分析  

Clinical distribution and antimicrobial resistance of infection caused by Antimicrbacter baumanni during the year 2009 to 2014 in Tung Wah Hospital

作　　者：郭主声[1] 张丽[1] 朱学海[1] 林偲思[1] 张丽华[1] 胡继华[1] 阎红霞[1] 周谋清 郭少卿[1] 

机构地区：[1]中山大学附属东莞东华医院检验科,广东东莞523110

出　　处：《海南医学》2015年第22期3329-3332,共4页Hainan Medical Journal

基　　金：东莞市科技局项目(编号:20131051010236)

摘　　要：目的了解东莞东华医院6年间临床分离鲍曼不动杆菌感染的分布情况及其耐药性变化趋势,为临床合理使用抗菌药物及有效控制感染提供依据。方法对我院2009-2014年临床送检标本进行常规微生物培养、鉴定和药敏试验,并用WHONET 5.6软件统计分析各病区各类标本中鲍曼不动杆菌的分布及耐药性的变化情况。结果于2009-2014年共检出鲍曼不动杆菌1 328株,以病房患者呼吸道标本检出为主,为1 000株,占75.3%,其次为伤口分泌物,为113株,占8.5%;鲍曼不动杆菌主要分布在ICU、脑外科、神经内科和呼吸内科。鲍曼不动杆菌对临床常用的14种抗菌药物耐药率以及临床分离率总体呈现出上升的势头,其中对亚胺培南和美洛培南的耐药率明显上升,亚胺培南的耐药率从2009年的2.9%上升至2014年的58.6%,美洛培南的耐药率从2009年的0.0%上升至2014年的59.4%;喹诺酮类及三代头孢的耐药率均呈不同幅度上升,且耐药率均大于50%。结论鲍曼不动杆菌耐药性呈上升趋势,耐药形势严峻,应了解临床分离的鲍曼不动杆菌耐药情况,及时监测其耐药现状,研究该菌的流行型别,为临床合理用药及控制医院感染提供依据。Objective To study the distribution and antibiotic resistance tendency of Acinetobacter baumannii in clinical specimens from 2009 to 2014 in our hospital, in order to provide referrence for appropriate use of antibiotics in clinic and to help carrying on the prevention and control of infection. Methods Clinical specimens from our hospital during 2009 to 2014 were collected for conventional microbiological culture, identification and antimicrobial sensitivity test. The distribution and antibiotic resistance tendency of A. baumannii were analyzed using WHONET 5.6 software.Results A total of 1 328 strains of A. baumannii were isolated, mainly from respiratory tract specimens（1 000 strains,accounting for 75.3%）, followed by wound secretion（113 strains, accounting for 8.5%）. A. baumannii mainly distributed in ICU, Department of Cerebral Surgery, Department of Neurology, and Department of Respiratory Medicine. The clinical detection rate and the antimicrobial resistance of A. baumannii to commonly used 14 antibiotics were on the rise generally. The drug resistance rates to Imipenem and Meropenem were increased significantly, from 2.9% and 0.0% in 2009 to 58.6% and 59.4% in 2014, respectively. The resistances to quinolones and third generation cephalosporin increased to different degrees, and the resistant rates were both more than 50%. Conclusion The drug resistance of A. baumannii is on the rise. Considering the serious situation, we should understand the clinical drug resistance situation of A. baumannii and timely monitor the resistance status, in order to provide basis for rational drug use and control of hospital infection.

关 键 词：鲍曼不动杆菌 抗菌药物 药敏试验 耐药性 

分 类 号：R378.99[医药卫生—病原生物学]