2016~2018年鲍曼不动杆菌临床分离株的 分布特征及耐药性变迁

目的 了解鲍曼不动杆菌在我院的分布特征及耐药性变迁，为临床合理选用抗菌药物提供依据。方法 采用珠海迪尔DL-96Ⅱ微生物分析仪进行细菌鉴定与药敏试验，对我院2016年1月~2018年12月临床各类标本中分离出的鲍曼不动杆菌的分布特征及耐药情况进行分析。结果 分离出551株鲍曼不动杆菌，年分离率相对稳定，但多重耐药鲍曼不动杆菌构成比上升明显，从67.28%上升到了82.21%。鲍曼不动杆菌主要分离自痰及咽拭子标本，占67.69%；感染主要发生在ICU病房、呼吸科和神经内科，其次为内分泌科和老干科。临床常用13种抗菌药物的耐药率与2016年比较，多种抗菌药物耐药率上升显著；2018年与2017年比较，耐药情况控制较好，其中米诺环素和多粘菌素B耐药率最低，分别为14.90%和16.35%；其余耐药率均大于55%。结论 鲍曼不动杆菌在我院耐药情况比较严重，对多种抗菌药物耐药率都达到了较高水平，临床应根据药敏结果和临床实际合理选用抗菌药物。

Distribution Characteristics and Drug Resistance Changes of Clinical Isolates of Acinetobacter Baumannii from 2016 to 2018

Abstract:Objective To understand the distribution characteristics and drug resistance changes of Acinetobacter baumannii in our hospital, and to provide a basis for clinical rational selection of antimicrobial agents.Methods The Zhuhai Deere DL-96Ⅱ microbiological analyzer was used for bacterial identification and drug susceptibility test. Analyzing the distribution characteristics and drug resistance of Acinetobacter baumannii isolated from various clinical specimens from January 2016 to December 2018 in our hospital.Results A total of 551 strains of Acinetobacter baumannii were isolated. The annual isolation rate was relatively stable, but the composition ratio of multi-drug resistant Acinetobacter baumannii increased significantly from 67.28% to 82.21%. Acinetobacter baumannii is mainly isolated from sputum and throat swab specimens, accounting for 67.69%; infection mainly occurs in ICU wards, respiratory and neurology, followed by endocrinology and cadaver. Compared with 2016, the resistance rate of 13 kinds of antibiotics commonly used in clinical practice increased significantly. The resistance rate of various antibiotics increased significantly. Compared with 2017, resistance was better controlled, among which minocycline and polymyxin B The drug resistance rate was the lowest, 14.90% and 16.35%, respectively; the remaining drug resistance rates were all greater than 55%.Conclusion The resistance of Acinetobacter baumannii in our hospital is quite serious, and the resistance rate to various antibiotics has reached a high level. The clinical application of antibiotics should be based on the results of drug susceptibility and clinical practice.