连续10年的鲍曼不动杆菌临床分离株的耐药谱变迁  

Drug resistance of Acinetobacter baumannii isolated from clinical specimens during 10 consecutive years

作　　者：江丹英 林雪峰[1] 王兵勇[1] 陈静[1] 应华永[2] 

机构地区：[1]温州医科大学附属乐清医院检验医学中心,浙江乐清325600 [2]浙江省金华市中心医院检验科,浙江金华321000

出　　处：《中国现代医生》2016年第6期93-96,共4页China Modern Doctor

基　　金：浙江省科技计划项目(2012C33023);浙江省温州市医药卫生科研项目(2015A17)

摘　　要：目的调查2005年1月~2014年12月鲍曼不动杆菌耐药谱变迁和来源分布,为临床合理选用抗菌药物提供依据。方法收集我院2005年1月~2014年12月临床标本中分离到的鲍曼不动杆菌,利用法国梅里埃公司的ATB自动鉴定仪和西门子Walk Away96全自动微生物分析仪进行菌种鉴定和药敏试验,数据分析采用WHONET5.6和MDR1.0。结果 10年中共分离到鲍曼不动杆菌1175株,分离菌株数和分离率呈不断增加趋势,鲍曼不动杆菌主要来源于呼吸道标本占80.0%,对17种抗菌药物的耐药率呈逐年上升趋势,上升最明显的是哌拉西林,从11.8%上升到82.6%,其次是碳青霉烯类抗菌药物,从0%上升至〉45%。多重耐药菌株和泛耐药菌株的检出也呈上升趋势,MDR-AB和XDR-AB分别从5.9%和0开始逐年升高,最高达65.6%和45.5%。结论连续监测鲍曼不动杆菌的来源分布和耐药变迁,对临床感染控制和治疗具有重要的意义。Objective To investigate the variation of drug resistance of Acinetobacter baumannii during 10 consecutive years（from Jan 2005 to Dec 2014）, so as to guide clinical therapy. Methods A.baumannii strains were isolated from clinical specimens dating from Jan 2005 to Dec 2014, subjected to bacterial identification and drug susceptibility testing by using ATB and Walk Away96 microbiology analyzer, respectively. The data was analyzed by using WHONET5.6 and MDR1.0. Results A total of 1175 strains of A.baumannii were isolated during this period with increasing strains and isolation rate.The strains were mainly isolated from the respiratory tract specimens, accounting for 80.0% and the drug resistance rates of the A.baumannii strains to 17 antimicrobial agents increased year by year during this period.The most significant increase was the drug resistance rate to the piperacillin, increasing from 11.8% to 82.6%, followed by the drug resistance rate to the carbapenems, increasing from 0 to greater than 45%. The numbers of the multiple resistant bacteria and P-resistence bacteria were increased year by year with MDR-AB from 5.9% to 65.6% and XDRAB from 0% to 45.5%, respectively. Conclusion It is of great significance in the clinical control and treatment of infections by consecutively monitoring the distribution and drug resistance of the A.baumannii.

关 键 词：鲍曼不动杆菌 分离率 来源分布 耐药性 

分 类 号：R378.9[医药卫生—病原生物学]