耐亚胺培南鲍曼不动杆菌的耐药性分析

目的探讨我院耐亚胺培南鲍曼不动杆菌的耐药特性。方法对2009年1月至2011年12月我院临床标本采用常规方法进行蓠株分离，采用Vitek-32全自动细茼鉴定药敏系统及绒片扩散法（K—B法）测定鲍曼不动杆菌对16种抗菌药物的敏感性。结果．共检测到91株鲍曼不动杆菌，其中耐亚胺墙南的鲍曼不动杆菌为23株（占25．3％），标本来源大部分为痰液（占94．9％）。耐亚胺培南鲍曼不动杆菌对常用16种抗蕾药物耐药率〉50％的有15种，耐药率〉90％有3种，分剐为氨苄西林（98．O％）、头孢唑林（99．O％）和呋喃妥因（99．0％），对抗菌药物耐药率最低仅为头孢哌嗣／舒巳坦（10．2％），另外检测到对所用抗菌素泛耐为4株（8．O％）；而对亚胺培南敏感的鲍曼不动杆菌对常用16种抗菌药物耐药率〉50％的仅为4种，耐药率〉90％同样为氨苄西林（100％）、头孢唑林（97．9％）和呋喃妥因（97．9％），耐药率比较低的为美罗培南（10．4％）、妥布霉素（16．7％）和环丙沙星（16．7％），耐药率最低也为头孢哌酮／舒巴坦（6．3％）。结论我院耐亚胺培南鲍曼不动杆茼多重耐药性严重，出现了泛耐菌株；临床可根据药敏试验选用抗茼药物，一般条件下耐亚胺培南鲍曼不动杆菌建议选用头孢哌嗣／舒巴坦。

Drug resistance of imipenem-resistant Acinetobacter baumannii

Objective To study the charaterlstics of drug resistance of imipenem - resistant A. baumannii from hospitalized patients. Method Carbapenem - resistant A. baumannii strains in clinical from January 2009 to December 2011 were collected and isolated by conven- tional methods. The susceptibility testing was performed withVitek - 32 and Kirby - Baner（KB） method. Result 91 A.baumannli isolates were collected, the main source of which was sputum, accounting for 94.9%, and 23 （25.3%） strains were imipenem - resistant. Them were 15 imipenem-resistant A.banmannii strains, resistance rates of which to 16 antimierobial agents were above 50%. The highest resistance rates were found to be against ampieillin （98.0%）, cefazolin （99.0%） and Nitrofurantoin （99.0%）, and the lowest resistance rates were against cefoperazone - subactam （i0.2%）.Besides＇ there were 4 pan- resistant strains, and there were 4 strains with the resistance rates to 16 antim icroblal agents above 50% in imipenem- sensitive A.baumannll group. And resistance rates above 90% were ampicfllin （100%）, cefazolin （97.9%） and N itrofurantoin （97.9%）, while the lowest resistance rate was found for Cefoperazone- sulbactam（6.3% ）. Conclusion The imipenem - resistant A. baunmmfii from hospitalized patients have severe multidrug resistance and pan - drug resistance. According to suscepti- bility testing of antimierobial agents, clinicians should select appropriate drugs. Generally, we may select cefoperazone - sulbactam to treat imipenem - resistant A. baumannii.