2014～2015年鲍曼不动杆菌的医院分离情况和耐药性分析  

Distribution and Drug-resistance of Acinetobacter Baumanii

作　　者：侯学伶[1] 孙岩[1] 李娜[1] 赵应飞 刘昱[1] 银广悦[1] HOU Xue- ling SUN Yan LI Na ZHAO Ying- fei LIU Yu YIN Guang- yue(The Laboratory of CNPCCH, Langfang 065000, Chin)

机构地区：[1]中国石油天然气集团公司中心医院检验科,河北廊坊065000

出　　处：《标记免疫分析与临床》2016年第12期1457-1459,共3页Labeled Immunoassays and Clinical Medicine

摘　　要：目的了解2014年至2015年鲍曼不动杆菌在本院的分布情况,并对其耐药性进行分析,为临床合理使用抗菌药物及控制院内感染提供依据。方法收集本院2014年1月至2015年12月间送检的各种临床标本,应用VITEK 2 Compact全自动微生物分析系统对临床分离的病原菌进行鉴定,同时用K-B药敏纸片法测定抗菌药物敏感率,结果按照CLSI标准判定。利用WHONT 5.6软件分析鲍曼不动杆菌的耐药性及其分布。结果重症监护病房(ICU)和呼吸科的鲍曼不动杆菌分离率最高,且以呼吸道标本为主,达90%以上;2014至2015年我院共分离出鲍曼不动杆菌212株,耐药结果显示,鲍曼不动杆菌对氨曲南、头孢他啶耐药明显,超过40%,对头孢呋辛钠表现出100%耐药,但亚胺培南、头孢哌酮-舒巴坦、复方磺胺甲恶唑对鲍曼氏不动杆菌仍有较好的抗菌作用(耐药率<25%),其中鲍曼不动杆菌对头孢哌酮-舒巴坦的耐药率最低,耐药率小于5%。结论鲍曼不动杆菌感染率不断上升,已成为ICU感染的主要病原菌,但由于其耐药性各不相同,对其进行耐药性分析,可以进一步指导临床合理使用抗生素,控制多重耐药鲍曼不动杆菌传播。Objective To investigate the distribution and drug-resistance of Acinetobacter baumanii （AB） in our hospital from 2014 to 2015 and to provide basis for rational drug use in clinical settings and control of nosocomial infections. Methods AB was isolated from clinical samples collected from January 2014 to December 2015, and the samples were identified with automatic analysis system VITEK 2 compact. Drug sensitivity was detected with the K-B method and determined according to CLSI standards. WHONET 5.4 softwares were used to analyze the data. Results Acinetobacter baumanii was most often isolated from respiratory specimens, the rates are more than 90%, and ICU and the department of respiratory medicine were primary locations. A total of 212 strains of Acinetobacter baumannii were isolated. Drug resistance rate of Acinetobacter baumannii toaztreonam and ceftazidime was more than 40%. Cefuroxime sodium showed 100% resistance. Imipenem, cefoperazone-sulbactam and cotrimoxazole for Acinetobacter baumannii still had better antibacterial effect （R 〈 25% ）. Antimicrobial susceptibility tests showed that AB had lowest resistances to cefoperazone/sulbactam in all antibacterial drugs（R 〈 5% ）. Conclusion The infection rate of Acinetobacter baumannii is rising. Acinetobacter baumannii has become the main pathogen of infection in ICU. Analysis of drug resistance can provide further guideline for clinical rational use of antibiotics and control the spread of the multiple drug resistant of acinetobacter baumanni.

关 键 词：鲍曼不动杆菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]