连续4年鲍曼不动杆菌感染分布及耐药性变迁

目的了解某院鲍曼不动杆菌（AB）在医院感染中的分布及耐药性变迁，为临床合理用药提供依据。方法对2008年1月-2011年12月住院患者送检的各类标本进行细菌培养分离，采用VITEK 2 compact全自动微生物仪进行菌株鉴定， K B纸片扩散法检测抗菌药物的敏感性。结果4年共分离AB 597株。AB在革兰阴性杆菌中所占比率，2008-2011年分别为：7.00%、8.35%、9.75%和12.66%，2011年较2008年明显上升，差异有统计学意义（χ2=32.77，P<0.05）。标本来源以痰标本最多，占70.86%；主要分离自老年病房（177株，29.65%）、肿瘤科（115株，19.26%）和神经内科（93株，15.58%）。AB对常用抗菌药物的耐药率在4年间均有逐年上升趋势（P<0.05）；2011年AB对美罗培南、头孢哌酮/舒巴坦、米诺环素的耐药率较低，分别为8.56%、6.95%、5.35%。结论AB的感染率和耐药率不断升高，加强对AB的监测，有利于临床合理选择抗菌药物，减少耐药菌株的产生与传播。

Distribution and change in antimicrobial resistance of Acinetobacter baumannii infection during consecutive four years

Objective To investigate the distribution and change in antimicrobial resistance of Acinetobacter bau- mannii （AB） in healthcare-associated infection（HAD in a hospital, so as to provide reference for rational use of anti- microbial agents. Methods AB isolated from clinical specimens between January 2008 and December 2011 were identified with Vitek 2-compact microbiology analyzer, antimicrobial susceptibility testing was performed by Kirby- Bauer disk diffusion method. Results A total of 597 AB isolates were isolated. The percentage of AB in gram-negative bacilli from 2008 to 2011 was 7. 00% ,8. 35% ,9. 75%, and 12. 66% respectively,percentage in 2011 rose obviously compared with 2008（Z2 = 32. 77, P〈0. 05）. The major specimen was sputum （70. 86%）, AB distributed mainly in elderly ward（177 isolates,29. 65%）, oncology department（ll5 isolates, 19. 26%）, and neurology department（93 isolates, 15. 58%）. Antimicrobial resistant rate of AB increased yearly during four years （P〈0. 05）, and resistant rate in 2011 to meropenem, cefoperazone/sulbactam and minocyeline was low （8. 56 %, 6. 95 %, 5.35 %, respectively）. Conclusion Infection and antimicrobial resistant rate of AB rise constantly, strengthening the monito- ring on AB is beneficial to guide rational use of antimicrobial agents in clinical practice and reduce the emergence and spread of drug-resistant strains.