2015—2017年某综合医院鲍曼不动杆菌耐药性监测

目的对某综合医院2015—2017年鲍曼不动杆菌分布及耐药性变化趋势进行分析,为临床合理用药提供参考依据。方法收集某医院2015—2017年临床标本中所分离的鲍曼不动杆菌,对不同时间段、不同病区来源鲍曼不动杆菌的耐药情况进行统计分析。结果共分离出鲍曼不动杆菌232株,分离率从2015年10.4%上升到2017年13.0%。标本来源以痰液最多,占76.3%;儿科、ICU、神经外科及呼吸内科是感染的高发病区。不同时间段分离鲍曼不动杆菌对抗菌药物耐药性具有一定波动,2016年的耐药性最低,2017年的耐药率最高。2017年鲍曼不动杆菌对头孢曲松、头孢他啶、氨苄西林/舒巴坦、头孢吡肟、亚胺培南的耐药率较2015年有增高趋势;左氧氟沙星、环丙沙星、妥布霉素和庆大霉素的耐药率保持稳定;复方磺胺甲噁唑的耐药率呈现下降趋势。来源于ICU病区鲍曼不动杆菌对抗菌药物的耐药性最为严重,神经外科及呼吸科病区耐药性次之,儿科病区耐药性最低。结论三年间该医院鲍曼不动杆菌分离率逐年增加,鲍曼不动杆菌对部分抗菌药物耐药性呈上升趋势,不同病区分离鲍曼不动杆菌对抗菌药物的耐药性具有差异,临床应及时进行细菌培养,根据病原菌耐药性的特点,合理使用抗菌药物。

Surveillance of Acinetobacter baumannii resistance in a General Hospital from 2015 to 2017

Objective The distribution of Acinetobacter baumannii and the trend of drug resistance in a general hospital from 2015 to 2017 were analyzed to provide a reference for clinical rational drug use.Methods Acinetobacter baumannii isolated from clinical specimens from 2015 to 2017 were collected and statistically analyzed for drug resistance in different time periods and strains from different wards.Results A total of 232 strains of Acinetobacter baumannii were isolated,and the isolation rate increased from 10.4%in 2015 to 13.0%in 2017.The source of the specimen was the most sputum,accounting for 76.3%.Pediatrics,ICU,Neurosurgery and respiratory medicine were the high-incidence areas of infection.Separation of Acinetobacter baumannii in different time periods has certain fluctuations in antimicrobial resistance.In 2016,the drug resistance was the lowest,and the resistance rate in 2017 was the highest.In 2017,the resistance rate of Acinetobacter baumannii to ceftriaxone,ceftazidime,ampicillin/sulbactam,cefepime,and imipenem was higher than that in 2015.Levofloxacin,ciprofloxacin,and tobra the resistance rate of mycin and gentamicin remained stable.The resistance rate to compound sulfamethoxazole showed a downward trend.Acinetobacter baumannii from the ICU ward has the most serious resistance to antibiotics,followed by neurosurgery and respiratory tracts,and pediatric wards have the lowest resistance.Conclusion The isolation rate of Acinetobacter baumannii in the hospital increased year by year.The resistance of Acinetobacter baumannii to some antibiotics showed an upward trend.The resistance of Acinetobacter baumannii to antimicrobial agents in different wards was different.Bacterial culture should be carried out in time for clinical use,and rational use of antibacterial drugs should be based on the characteristics of drug resistance of pathogenic bacteria.