2010～2017年山东省ICU鲍曼不动杆菌及肺炎克雷伯菌耐药情况  

Drug resistance changes of Acinetobacter baumannii and Klebsiella pneumoniae in ICU of Shandong Province from 2010 to 2017

作　　者：朱丽娟 孙德华 姜志明[2] 李涛[2] ZHU LiJuan;SUN Dehua;JIANG Zhiming;LI Tao(Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院,山东潍坊261053 [2]山东省千佛山医院

出　　处：《山东医药》2019年第7期19-22,共4页Shandong Medical Journal

基　　金：山东省医药卫生科技发展计划项目(2017WS363)

摘　　要：目的了解山东省34所医院ICU临床分离鲍曼不动杆菌及肺炎克雷伯菌的耐药性变化趋势,为指导临床抗菌药物合理的应用提供依据。方法对2010年1月1日～2017年12月31日山东省ICU细菌耐药监测协作网平台34所医院分离的鲍曼不动杆菌及肺炎克雷伯菌进行回顾性分析,采用纸片扩散法(K-B法)做药物敏感试验,根据CLSI(2016版)判定药敏结果,采用WHONET5.6软件进行统计分析。结果共分离病原菌87 542株,其中鲍曼不动杆菌25 299株(28.90%)、肺炎克雷伯菌13 538株(15.46%)。鲍曼不动杆菌和肺炎克雷伯菌8年检出率均呈增加趋势,其标本来源以呼吸道标本为主,分别为84.33%和79.59%,其次是血标本、尿标本、引流液标本、伤口渗液和脑脊液。鲍曼不动杆菌对米诺环素、头孢哌酮/舒巴坦、美罗培南、亚胺培南、哌拉西林/他唑巴坦、头孢吡肟、头孢他啶的耐药率均呈上升趋势;肺炎克雷伯菌对美罗培南、亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率均呈逐年增高趋势,但对阿米卡星有下降趋势。结论 2010～2017年,山东省ICU感染鲍曼不动杆菌及肺炎克雷伯菌对常用抗菌药物耐药率呈总体上升趋势,尤其对碳青霉烯类抗菌药的耐药情况日趋严重。Objective To investigate the changes of drug resistance of Acinetobacter baumannii and Klebsiella pneumoniae in intensive care unit (ICU) of 34 hospitals in Shandong Province and to provide a basis for the rational uses of clinical antibacterial drugs.Methods The isolated date of Acinetobacter baumannii and Klebsiella pneumoniae collected from January 1, 2010 to December 31, 2017 were retrospective analyzed in 34 hospitals from Shandong ICU Bacterial Resistance Monitoring and Collaboration Network Platform. We used Kirby-Bauer method (K-B method) to test drug sensitivity, and determined the drug sensitivity by CLSI (2016 edition), and used software WHONET5.6 for statistical analysis. Results A total of 87 542 cases of pathogenic bacteria were isolated with 25 299 (28.90%) of Acinetobacter baumannii and 13 538 (15.46%) of Klebsiella pneumoniae. The 8-year detection rates of Acinetobacter baumannii and Klebsiella pneumoniae increased, and the specimens were mainly from respiratory specimens, which were 84.33% and 79.59%, respectively, followed by blood specimens, urine specimens, drainage specimens, wound seepage, and cerebrospinal fluid. The drug resistance rates of Acinetobacter baumannii to minocycline, cefoperazone/sulbactam, meropenem, imipenem, piperacillin/tazobactam, cefepime and ceftazidime were on the rise;the drug resistance rates of Klebsiella pneumonia to meropenem, imipenem, cefoperazone/sulbactam, piperacillin/tazobactin increased year by year, but it had an downward trend to amikacin. Conclusions From 2010 to 2017, the resistance rates of Acinetobacter baumannii and Klebsiella pneumoniae to common antibacterial drugs in ICU of Shandong Province showed an overall upward trend, especially the resistance to carbapenems.

关 键 词：鲍曼不动杆菌 肺炎克雷伯菌 细菌耐药 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]