鲍曼不动杆菌感染的临床分布及耐药性分析

目的：了解我院鲍曼不动杆菌的临床分布和耐药情况，以指导临床合理用药。方法：采用法国梅里埃的VITEK-2微生物鉴定系统对临床各科送检标本进行鲍曼不动杆菌的鉴定，药敏试验采用K-B纸片扩散法；采用WHONET 5.3软件进行数据统计分析。结果：分离出的865株鲍曼不动杆菌主要来自呼吸道标本，分离率居前3位科室依次为呼吸内科、ICU（重症监护室）、普通外科，分别占40.6%、29.1%、18.0%。对常用抗菌药物的耐药率最低的是米诺环素35.0%，其次为头孢哌酮/舒巴坦43.0%，对其他抗菌药物的耐药率均大于51.0%，其中对亚胺培南耐药率大于90.0%。结论：我院鲍曼不动杆菌耐药十分严重，临床分离出的鲍曼不动杆菌多为多重耐药甚至泛耐药菌株。头孢哌酮/舒巴坦和米诺环素对鲍曼不动杆菌仍有较好的体外抗菌活性。临床应重视合理应用抗菌药物，以减少耐药菌株的产生。

CLINICAL DISTRIBUTION AND DRUG RESISTANT ANALYSIS OF ACINETOBACTER BAUMANNII

Objective：To study the clinical distribution and drug resistance of Acinetobacter Baumannii（ AB ） , and guide the reasonable using of antibiotics in the clinic. Methods：VITEK-2 system was used to do identification, drug sensitivitity were detected by Kirby-Bauer disc diffusion method. WHONET 5. 3 soft ware was adopted to analyze the drug resistance. Results：865 strains of A. baumannii were isolated mainly from respiratory tract specimens. The department of respiratory medicine,ICU,and department of general surgery were the top 3 departments from which the strains were isolated, accounting for 40. 6%, 29. 1%, and 18. 0% respectively. A. baumannii strains were highly resistant to the commonly used antibiotics,the drug resistance rate to minocycline was the lowest （ 35 . 0%） , followed by cefoperazone/sulbactam （ 43 . 0%）. The drug resistance rates to other antibiotics were all higher than 51%, the drug resistance rate to imipenem was higher than 90 . 0%.Conclusion：The drug resistance of A. baumannii is serious in our hospital. The most of A. baumannii strains isolated from our hospital are multiple-drug resistant and pan-drug-resistant strains. Cefoperazone/sulbactam and minocycline still has good antibacterial activity against A. baumannii. Great importance should be attached to rational use of antibiotics to decrease the generation of new types of drug-resistant bacterial strains.