鲍氏不动杆菌医院分离株3年耐药性动态监测  

Dynamic monitoring of drug resistance of Acinetobacter baumannii strains isolated from a hospital in 3 years

作　　者：梁建国[1] 孔双红 张才仕 陈风[3] 秦声远 LIANG Jian-guo KONG Shuang-hong ZHANG Cai-shi CHEN Feng QIN Sheng-yuan(Hubei Jianli County Renming Hospital, Jianli, Hubei 433300, Chin)

机构地区：[1]湖北省监利县人民医院设备科,湖北监利433300 [2]湖北省监利县人民医院医疗服务中心,湖北监利433300 [3]湖北省监利县人民医院检验科,湖北监利433300

出　　处：《中华医院感染学杂志》2017年第4期735-738,共4页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金项目(WJ01564)

摘　　要：目的统计3年来医院检验科分离的鲍氏不动杆菌(ABA)流行株的耐药性,为地域性耐药监测和临床选药提供依据。方法 2013年1月-2015年12月,进行感染患者标本取样、细菌培养及药敏检测,逐年更新CLSI折点,评判ABA对规定的抗菌药物敏感、中介、耐药情况,用WHONET5.6软件对数据进行统计处理。结果 3年共检出363株ABA,2013年、2014年、2015年分别是99株,126株,138株,分别占ABA总数的27.3%、34.7%、38.0%;ABA检出率最高的部位是呼吸道,其次是泌尿道;3年来ABA对医院常用抗菌药物的耐药率总体表现为逐年上升,该菌对多粘菌素B、米诺环素、头孢哌酮/舒巴坦等有较低的耐药率,均<20%;而对磺胺甲噁唑∕甲氧苄啶、庆大霉素、环丙沙星、哌拉西林、头孢他啶耐药率较高,均>50%,尚未分离到对多粘菌素B耐药菌株。结论江汉平原医院分离ABA流行株的医院感染率迅速上升,医院须阻止流行菌株耐药性日益加重的危险现象,努力提高抗感染疾病的医疗水平。OBJECTIVE To statistically analyze the drug resistance of Acinetobacter baumannii strains isolated from clinical laboratory department in recent three years so as to provide guidance for surveillance of regional drug resistance and clinical use of antibiotics.METHODS From Jan 2013 to Dec 2015,the specimens were collected from the patients with infection.The bacterial cultivation and the drug susceptibility testing were conducted.The CLSI breakpoints were updated year by year,and the susceptibility result（susceptible intermediate resistant）of the A.baumannii strains to designated antibiotics were determined and evaluated.In addition,statistical analysis of data was performed with the use of WHONET5.6software.RESULTS Totally 363 strains of A.baumannii were isolated in the three years,of which 99（27.3%）were isolated in 2013,126（34.7%）in 2014,138（38.0%）in 2015.The isolation rate of the A.baumannii strains was highest in respiratory tract,followed by urinary tract.The drug resistance rate of the A.baumannii strains to the commonly used antibiotics generally showed an upward trend in the three years;the drug resistance rates to polymyxin B,minocycline,and cefoperazone-sulbactam were less than20%,however,the drug resistance rates to sulfamethoxazole-trimethoprim,gentamicin,ciprofloxacin,piperacillin,and ceftazidime were more than 50%;the strains resistant to polymyxin B had not been detected.CONCLUSIONThe incidence rate of nosocomial infection caused by the epidemic A.baumannii strains is increased rapidly in the hospital of Jianghan Plain.It is necessary for the hospital to prevent rapid increase of the drug resistance of the epidemic strains and try to improve the level of treatment of infectious diseases.

关 键 词：鲍氏不动杆菌 流行株 动态监测 耐药性 

分 类 号：R378[医药卫生—病原生物学]