2012年～2016年某院重症监护室鲍曼不动杆菌分布及耐药性分析  

Clinical distribution and antimicrobial resistance of Acinetobacter baumannii isolated in ICU between 2012 and 2016 in a hospital

作　　者：刘小琴[1] 徐治波[1] 虎琼华[1] 崔巍[1] 保勇[1] 尹亚非[1] 史梦 LIU Xiao-qin;XU Zhi-bo;HU Qiong-hua(The Second People＇ s Hospital of Chengdu,Chengdu 610017,China)

机构地区：[1]成都市第二人民医院,四川成都610017

出　　处：《吉林医学》2018年第9期1675-1678,共4页Jilin Medical Journal

摘　　要：目的:了解2012年~2016年成都市第二人民医院重症监护室鲍曼不动杆菌的临床分布与耐药性变化趋势,为耐药菌防控及经验用药提供参考依据。方法:对成都市第二人民医院重症监护室2012年1月~2016年12月分离的鲍曼不动杆菌来源和药敏试验结果进行统计分析。结果:2012年~2016年重症监护室送检标本共分离细菌1 965株,其中鲍曼不动杆菌551株(28.04%),5年鲍曼不动杆菌分别占分离病原菌的26.23%(90/343)、26.03%(107/411)、34.31%(152/443)、30.56%(114/373)、22.28%(88/395)。标本来源主要为痰(521株,94.56%)。2012年~2016年对亚胺培南耐药率分别为86.7%、89.7%、95.4%、93%、86.4%,对头孢哌酮舒巴坦耐药率分别为14.3%、3.6%、23.1%、32.7%、50.8%,对复方新诺明的耐药率分别为0、0、9.3%、31%、70.1%,2014年~2016年对替加环素耐药率分别为3.1%、3.7%、3.4%,对其他类常用抗生素耐药率基本在50%以上。结论:成都市第二人民医院重症监护室鲍曼不动杆菌的分离率高,耐药率高,多重耐药及泛耐药现象明显,亚胺培南耐药率超过80%,对头孢哌酮舒巴坦耐药率呈总体上升趋势,复方新诺明耐药率快速上升,对替加环素保持较低耐药率。临床科室对比应予以重视,加强防控措施,规范应用抗生素,加强耐药性监测分析,指导临床经验用药。Objective To investigate the clinical distribution and change in antimicrobial resistance of Acinetobacter baumannii（ A. baumannii） in ICU in my hospital between 2012 and 2016,so as to provide guidance for prevention and clinical treatment. Method The source and drug sensitivity test of Acinetobacter Bauman isolated from January 2012 to December 2016 in the intensive care unit of our hospital were analyzed. Results A total of 1 965 strains of bacteria were isolated from the intensive care unit in 2012-2016,28. 04%（ n = 551） of which were A. baumannii isolates,the percentageof A. baumanniiin isolated pathogens in 5 years was 26. 23%（ 90/343） 、26. 03%（ 107/411） 、34. 31%（ 152/443） 、30. 56%（ 114/373） 、22. 28%（ 88/395） respectively. The main specimen was sputum（ n = 521,94. 56%）. The resistant rates of imipenem were 86. 7%,89. 7%,95. 4%,93% and 86. 4% respectively. The resistance rates to cefoperazone sulbactam were 14. 3%,3. 6%,23. 1% 32. 7% and 50. 8%respectively. The resistance rates to cotrimoxazole were 0,0,9. 3%,31%,and 70. 1% respectively,The resistance rates of tigecycline were 3. 1%,3. 7% and 3. 4% respectively betwwen 2014 and 2016,and the resistance rate of other commonly used antibiotics was more than 50%. Conclusion Isolation rate and antimicrobial resistance rate of A. baumannii strains are both high in ICU,multidrug-resistant and extensively drug-resistant A. baumannii strains are obvious,The resistant rates of imipenem were more than 80%,The cefoperazone sulbactam resistance rate showed an overall upward trend,The resistance rate of compound neomycin was increase rapidly,And there is a maintenance of a lower resistance rate to tigecycline. We should pay more attention to prevention and control measures,application of antibiotics,drug resistance monitoring and analysis,so as to provide guidance for clinical medication.

关 键 词：重症监护室 鲍曼不动杆菌 耐药性 多重耐药 泛耐药 

分 类 号：R446.5[医药卫生—诊断学]