神经外科鲍曼不动杆菌的标本分布、耐药性及其产金属酶的情况分析

目的了解神经外科鲍曼不动杆菌(ABA)的标本分布、耐药性及其金属β内酰胺酶(MBLs)产生情况。方法对2010年1月至2012年6月观澜人民医院神经外科分离的459株ABA,用VITEK 2 Compact全自动微生物分析系统检测其对18种抗生素的药敏谱,用双纸片协同试验检测MBLs产生情况。结果我院神经外科ABA痰标本的构成比为88.02%(404/459);对氨苄西林、头孢唑林、呋喃妥因、头孢替坦严重耐药,耐药率均超过85%;256株对亚胺培南耐药的多重耐药菌株中,筛选出151株产MBLs的菌株,产生率为59.0%(151/256),占总检出株数的32.9%(151/459);MBLs菌株耐药情况严重,对其中7种抗生素为全耐药,另有10种抗生素的耐药率在80%以上;MBLs菌株与非MBLs菌株的耐药率比较,除头孢唑林、呋喃妥因、头孢替坦外,其余15种抗生素的耐药率差异均有统计学意义(P<0.01)。结论神经外科ABA主要分离自痰液,耐药情况严重,了解神经外科ABA的标本分布、耐药性及其MBLs产生情况,对治愈ABA引起的感染及控制MBLs菌株的流行具有重要意义。

Analysis of Distribution,Resistance and Its Production of Metal Enzyme of Acinetobacter Baumannii Specimen in Neurosurgery Department

Objective To understand the specimens distribution,resistance and its metal beta-lactamase(MBLs) production of acinetobacter baumannii(ABA) in neurosurgery department.Methods Four hundred and fifty-nine strains of Neurosurgery separated ABA from Guanlan People's Hospital from Jan.2010 to Jun.2012 were tested with the VITEK 2 compact automated microbial analysis system to detect the antibiotic susceptibility spectrum to 18 antibiotics,and the MBLs production was tested by double disk synergy.Results The ABA sputum specimen constitution ratio of the neurosurgery department was 88.02%(404 /459);serious resistance to AMP,CZO,FTN and CTT was observed with the resistance rates all over 85%;151 strains producing MBLs among the 256 strains with multi-drug-resistance resistant to imipenem(IPM) were screened out forming a production rate of 59.0%(151 /256),32.9% of the total detected number of strains(151/459);MBLs strains have serious drug resistance,with total resistance to seven kinds of antibiotics observed,and over 80% resistance to another 10 kinds of antibiotics;the MBLs strain and non-MBLs strain resistance rate comparison: except CZO,FTN,CTT,the differences of the remaining 15 kinds of antibiotics were all statistically significant(P < 0.01).Conclusion ABA is mainly isolated from sputum in neurosurgery department,the drug resistance of which is serious;understanding the specimens distribution,resistance and its MBLs production is of great significance for curing ABA caused infection and controlling the spread of MBLs strains.