鲍曼不动杆菌的多重耐药性分析  

Phenotype analysis of multiple antibiotic resistance of acinetobacter baumannii

作　　者：赵建平 陈怡菲[2] 周秀岚[3] 

机构地区：[1]内蒙古自治区人民医院检验科,呼和浩特010010 [2]内蒙古医科大学2014级临床检验诊断学专业硕士研究生,呼和浩特010050 [3]内蒙古医科大学附属医院药剂部,呼和浩特010050

出　　处：《中国医药》2017年第4期614-618,共5页China Medicine

基　　金：内蒙古自治区科技计划（201502107）;内蒙古自治区人民医院院内基金（201417）

摘　　要：目的探讨医院2011—2015年鲍曼不动杆菌（AB）的多重耐药性分析。方法回顾性分析2011年1月至2015年12月在内蒙古自治区人民医院就诊的患者中检出AB 1 249株,其中亚胺培南耐药AB（IRAB）989株，亚胺培南非耐药AB（ISAB）260株。记录AB的标本来源、主要病区分布；计算主要病区IRAB的检出率；分析比较IRAB和ISAB对13种药物的耐药性差异。结果在5年中，从痰液中检出AB最多，占80.3%（1 003/1 249），从尿液、脓汁（包括分泌物标本）和血液中检出AB分别占5.0%（62/1 249）、4.9%（61/1 249）、2.1%（26/1 249）。AB主要以重症监护病房分布为主，其占比明显高于神经内科、神经外科和干部保健病房［46.0%（574/1 249）比14.3%（178/1 249）、8.1%（101/1 249）、7.3%（91/1 249）］，差异均有统计学意义（均P＜0.05）。在5年中，神经外科和干部保健病房IRAB检出率明显低于重症监护病房和神经内科［76.2%（77/101）、58.2%（53/91）比96.2%（552/574）、82.7%（163/197）］，差异均有统计学意义（均P＜0.05）。在5年中，AB对阿米卡星耐药率在36.5%（92/252）以下，对其他大多数抗菌药物耐药率在53.4%（174/326）以上。IRAB对阿米卡星耐药率最低，为28.1%（278/989），其次复方新诺明为49.8%（492/989），对其他11种抗菌药物耐药率为83.0%（830/989）～100.0%（989/989）；而ISAB对哌拉西林/他唑巴坦、盐酸头孢吡肪、亚胺培南和阿米卡星耐药率均在7.3%（19/260）以下，对其他9种抗菌药物耐药率为15.4%（40/260）～29.6%（77/260）。ISAB对13种抗菌药物的耐药率均明显低于IRAB，差异均有统计学意义（均P＜0.05）。结论IRAB的检出率及对多种抗菌药物耐药性较高，医院应加强管理和控制，做好隔离和消毒工作。ObjectiveTo analyze the multiple antibiotic resistance of acinetobacter baumannii（AB） from 2011 to 2015 in hospital. MethodsTotally 1 249 strains of AB were detected in Inner Mongolia People′s Hospital from January 2011 to December 2015, including 989 strains of imipenem-resistance AB（IRAB） and 260 strains of imipenem-non-resistance AB（ISAB）. Source of specimen and distribution of wards were recorded; detection rates of IRAB in main wards were calculated; resistance rates to 13 types of antibiotics were analyzed between IRAB and ISAB. ResultsDetection rate of AB from sputum was 80.3%（1 003/1 249）; detection rates of AB from urine, pus/secretion and blood were 5.0%（62/1 249）, 4.9%（61/1 249） and 2.1%（26/1 249）. AB was mainly detected in Intensive Care Unit, the detection rate was significantly higher than that in Departments of Neurology, Neurosurgery and Ward of Cadres Health Care[46.0%（574/1 249） vs 14.3%（178/1 249）, 8.1%（101/1 249）, 7.3%（91/1 249）]（P〈0.05）. Detection rates of IRAB in Department of Neurosurgery and Ward of Cadres Health Care were significantly lower than those in Intensive Care Unit and Department of Neurology[76.2%（77/101）, 58.2%（53/91） vs 96.2%（552/574）, 82.7%（163/197）]. Resistance rate of AB to amikacin was below 36.5%（92/252）; resistance rates of AB to other antibiotics were above 53.4%（174/326）. Resistance rates of IRAB to amikacin and sulfamethoxazole compound were 28.1%（278/989） and 49.8%（492/989）; resistance rates of IRAB to other antibiotics were 83.0%（830/989）-100.0%（989/989）. Resistance rates of ISAB to piperacillin/tazobactam, cefepime hydrochloride, imipenem and amikacin were below 7.3%（19/260）; resistance rates of ISAB to other antibiotics were 15.4%（40/260）-29.6%（77/260）. Resistance rates of ISAB to 13 types of antibiotics were significantly lower than those of IRAB（P〈0.05）. ConclusionsDetection rate and antibiotic resistance rate for many antibacterial drugs of IRAB are hi

关 键 词：鲍曼不动杆菌 亚胺培南 多重耐药 

分 类 号：R378[医药卫生—病原生物学]