870株不动杆菌的分布及耐药性分析  

The distribution and drug resistance of 870 strains of acinetobacters

作　　者：储从家[1] 李杰芬[1] 吴惠玲[1] 罗云梅[2] 李云辉[3] 陈丽红[4] CHU Congjia LI Jiefen WU Huiling LUO Yunmei LI Yunhui CHEN Lihong(People＇s Hospital of Yuxi City, Yuxi, Yunnan 653100, China)

机构地区：[1]玉溪市人民医院检验科,云南玉溪653100 [2]玉溪市人民医院护理部,云南玉溪653100 [3]玉溪市人民医院药剂科,云南玉溪653100 [4]玉溪市人民医院医院感染管理科,云南玉溪653100

出　　处：《中国微生态学杂志》2016年第11期1313-1315,共3页Chinese Journal of Microecology

摘　　要：目的了解玉溪市人民医院不动杆菌属细菌的分布及耐药谱分析,为临床用药提供依据。方法对玉溪市人民医院2014年1月至12月临床各科室送检的各类标本培养分离出的870株不动杆菌属细菌作回顾性分析。结果 870株不动杆菌属细菌含5个种,鲍曼不动杆菌数量最多,占84.60%(736/870),洛菲不动杆菌和琼氏不动杆菌次之,分别为8.05%(70/870)和6.55%(57/870)。重症医学科分离菌数最多,占30.00%(261/870),神经内科和呼吸内科次之,分别为19.20%(167/870)和11.49%(100/870)。口痰样本分离菌数最多,占76.21%(663/870),其次为体液11.84%(103/870),第三位为咽拭6.09%(53/870)。不同种(鲍曼、洛菲和琼氏)不动杆菌对阿米卡星、阿莫西林/克拉维酸、氨苄西林、呋喃妥因、复方新诺明、环丙沙星、美罗培南、哌拉西林、庆大霉素、头孢吡肟、头孢曲松、头孢他啶、头孢唑啉、亚胺培南和左氧氟沙星的耐药率有显著差异(P<0.01);鲍曼不动杆菌除对左氧氟沙星和四环素耐药率小于30%外,其余均大于57%以上。洛菲和琼氏不动杆菌对上述16种抗菌药物的耐药率除头孢唑啉和呋喃妥因大于55%外,其余均小于22%。结论不动杆菌为医院感染的主要条件致病菌,不同种的不动杆菌对常用抗菌药物的耐药率有明显差异,应定期监测细菌变迁和耐药性变化,指导临床合理用药。Objective To investigate the distribution and their drug resistance of acinetobacters in People′s Hospital of Yuxi City and provide the basis for clinical use.Methods A total of 870 Acinetobacter strains clinically isolated from various specimens in People′s Hospital of Yuxi City from January 2014 to December2014 were retrospectively analyzed.Results The 870 strains of acinetobacters contained five species.Acinetobacter baumannii was predominant,accounting for 84.60%（736/870）,followed by Loffi Acinetobacter and Joan A.baumannii accountingfor 8.05%（70/870）and 6.55%（57/870）,respectively.The majority of the strains were isolated from Critical Care Medicine department,representing 30.00%（261/870）,followed by respiratory medicine and neurology departments,19.20%（167/870）and11.49%（100/870）respectively.These Acinetobacter isolates were mostly found in sputum specimens,representing 76.21%（663/870）,followed by body fluids,11.84%（103/870）,and pharyngeal swab,6.09%（53/870）.The drug resistance rates of different Acinetobacter species（Acinetobacter baumannii,Loffi Acinetobacter and Joan A.baumannii）to Amikacin,Amoxicillin/clavulanic acid,Ampicillin,Nitrofurantoin,Cotrimoxazole,Ciprofloxacin, Meropenem,Piperacillin,Gentamicin,Cefepime,Ceftriaxone,Ceftazidime,Cefazolin,Imipenem and Levofloxacin were significantly different（P〈0.01）.The drug resistance rates of Acinetobacter baumannii to Levofloxacin and Tetracycline were less than 30%,while those to the rest were more than 57%.The drug resistance rates of Loffi and Joan A.baumannii to Cefazolin and Nitrofurantoin were greater than 55%,while those to the rest were less than 22%.Conclusion Acinetobacters were main pathogens of nosocomial infections.There were significant difference in the drug resistance rates to commonly used antimicrobial drugs between different species of Acinetobacter.The hospital should regularly monitor the changes of the bacteria and their drug resistances in order to guide rational drug use.

关 键 词：不动杆菌 分布 抗菌药物 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]