2011-2013年鲍氏不动杆菌的临床分布与耐药性分析  

Clinical distribution and drug resistance of Acinetobacter baumannii strains isolated from 2011 to 2013

作　　者：高瑞灏[1] 刘德美[2] 王有森[1] 王智亮[1] 周维青[1] 

机构地区：[1]潍坊市人民医院药剂科,山东潍坊261041 [2]潍坊市人民医院检验科,山东潍坊261041

出　　处：《中华医院感染学杂志》2016年第9期1927-1929,共3页Chinese Journal of Nosocomiology

基　　金：山东省卫生厅基金资助项目(SW-2009B109)

摘　　要：目的分析3年鲍氏不动杆菌的临床分布特点和耐药性变化,指导临床用药,控制医院感染。方法选取2011年1月-2013年12月临床送检的11 384份标本,采用法国生物梅里埃公司的VITEK-32全自动微生物鉴定仪及相关试剂进行培养、分离和鉴定,药敏试验采用K-B法。结果 11 384份标本中共检出鲍氏不动杆菌1 576株,检出率为13.84%,2011-2013年历年检出率分别为10.48%、14.07%和16.67%;鲍氏不动杆菌的主要标本来源为痰液、咽拭子分泌物和肺泡灌洗液,分别占44.23%、21.07%和11.67%;鲍氏不动杆菌的主要感染部位为呼吸道占76.97%,其次为皮肤软组织占13.39%;2011-2013年鲍氏不动杆菌对常见抗菌药物的耐药性均呈逐渐增强趋势,对多种常用抗菌药物表现出较强的耐药性,对亚胺培南和美罗培南耐药率也相对较高,对头孢哌酮/舒巴坦耐药率最低。结论鲍氏不动杆菌的检出率逐年增加,其耐药性也逐年增强,临床必须加以重视。OBJECTIVE To investigate the clinical distribution and drug resistance of Acinetobacter baumannii strains isolated from the past three years so as to provide guidance for clinical use of antibiotics and control of nosocomial infections.METHODS A total of 11 384 clinical submitted specimens were collected from Jan 2011 to Dec2013,then they were cultured,isolated,and identified by using VITEK-2automatic microorganism identification system of BioMérieux,France,as well as related reagents,and the drug susceptibility testing was performed by using K-B method.RESULTS Totally 1 576 strains of A.baumannii were isolated from the 11 384 specimens,with the isolation rate 13.84%;the isolation rate was 10.48%in 2011,14.07%in 2012,16.67%in 2013.Of the isolated A.baumannii strains,44.23% were isolated from sputum specimens,21.07%from throat swab secretions,11.67%from alveolar lavage fluid.Among the patients with A.baumannii infection,76.97% had respiratory tract infection,and 13.39% had skin and soft tissue infection.The drug resistance of the A.baumannii strains to the commonly used antibiotics showed an increasingly upward trend from 2011 to 2013,the strains were highly resistant to multiple commonly used antibiotics,the drug resistance rates to imipenem and meropenem were relatively high,and the drug resistance rate to cefoperazone-sulbactam was the lowest.CONCLUSION The isolation rate of the A.baumannii strains is increased year by year,so is the drug resistance,and it is necessary for the hospital to pay high attention.

关 键 词：鲍氏不动杆菌 药敏试验 耐药性 碳青霉烯类 

分 类 号：R378[医药卫生—病原生物学]