医院感染鲍氏不动杆菌分布与耐药性分析  

Survey on distribution and drug resistance of Acinetobacter baumannii in a general hospital

作　　者：杨淑香[1] 王莎莎[1] 陈会波[1] 杜明梅[2] 邢玉斌[2] 索继江[2] 贾宁[2] 高岩[2] 任世旺[2] 刘伯伟[2] 谢丽君[2] 刘运喜[2] 

机构地区：[1]潍坊医学院公共卫生学院,山东潍坊261053 [2]解放军总医院感染管理与疾病控制科,北京100853

出　　处：《中华医院感染学杂志》2016年第6期1232-1234,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30872155);国家科技重大专项"艾滋病和病毒性肝炎等重大传染病防治"基金资助项(2013ZX10004 805-003);全军医学科技"十二五"科研基金资助项目(重大专项AWS11L009)

摘　　要：目的了解医院感染鲍氏不动杆菌的临床分布特点与耐药性,为控制医院感染提供依据。方法收集2011-2013年医院感染实时监控系统,回顾性分析综合医院临床送检标本鲍氏不动杆菌检测结果及其耐药性;采用法国生物梅里埃公司VITKE-2Campact全自动细菌鉴定仪进行菌株鉴定,药敏试验采用K-B纸片琼脂扩散法,使用SPSS 17.0软件进行统计分析。结果 2011-2013年医院住院患者送检标本中检出病原菌25 758株,其中鲍氏不动杆菌2 543株,检出率为9.9%;标本主要来自重症监护病房、呼吸内科、神经内科;鲍氏不动杆菌送检标本分离率居首位的是痰液;临床分离2 543株鲍氏不动杆菌对哌拉西林/他唑巴坦、氨苄西林/舒巴坦、头孢他啶、头孢吡肟、头孢呋辛、头孢噻肟、头孢曲松、亚胺培南、四环素、环丙沙星耐药率>80.0%,对庆大霉素和阿米卡星的耐药率分别为79.5%和78.5%;只对少数抗菌药物,如氨苄西林、阿莫西林/克拉维酸、头孢唑林、氨曲南、呋喃妥因的耐药率<20.0%。结论综合医院分离鲍氏不动杆菌临床分布主要集中在重症监护病房,其耐药率较高,并且多数呈现广泛耐药,应重视鲍氏不动杆菌感染的预防和监测,并对其耐药机制做进一步研究。OBJECTIVE To understand the distribution and drug resistance of detected A.baumanii from inpatients of a general hospital,so as to provide scientific basis for reasonable use of antibiotics.METHODS Totally 2 543 clinical isolates from clinical patients between 2011 and 2013were collected.The test results and drug resistance of A.baumannii were retrospectively analyzed.Strains were identified by VITKE-2Campact system and the drug sensitivity test was performed by K-B method.The software SPSS 17.0was used for statistical analysis.RESULTS There were 2 543 A.baumanii strains isolated from the 25 758 pathogenic strains from the delivered specimens during the three years,with the detection rate of 9.9%.Specimens were mainly from departments of ICU,respiratory medicine and neurology medicine.The most A.baumanii were detected from sputum specimens.The total resistance rates in three years for A.baumanii were more than 80.0% to piperacillin/lazobactain,ampicillin/sulbactam,cftazidine,cefepime,cefuroxime,ceftriaxone,imipenema,tetracycline and ciprofloxacin,79.5%to gentamicin and 78.5%to amikacin.The resistance rate was20.0%to few antibiotics such as ampicillin,amoxicillin/clavulanic acid,cefazolin,aztreonam and nitrofurantoin.CONCLUSIONClinical distribution of isolated A.baumanii in the hospital mainly concentrated in ICU,the drug resistance was high and most strains were multi-drug resistant,so clinicians should strengthen the monitoring and prevention of A.baumanii infection and make further research on the resistance mechanisms.

关 键 词：鲍氏不动杆菌 多药耐药菌 医院感染 耐药性 

分 类 号：R644[医药卫生—外科学]