近三年川东北地区鲍曼不动杆菌分布及耐药性分析

目的:分析川东北地区某医院临床分离鲍曼不动杆菌的分布特点和耐药变迁,为该菌所致感染性疾病的有效防治提供实验室依据。方法:分析2013年1月至2015年12月临床各科室送检标本中鲍曼不动杆菌的检出情况、分布特点和药敏试验。结果:近三年鲍曼不动杆菌分离率分别是2.2%(425)、2.0%(342)和1.5%(297)。1064株鲍曼不动杆菌主要分离自呼吸道痰标本(76.2%),其次为脓液(13.8%),其他标本检出率较低。鲍曼不动杆菌以ICU检出率最高(38.1%),其次为神经外科(20.9%),外科的检出率高于内科。2013年至2015年耐药率总体呈上升趋势,其中头孢哌酮/舒巴坦的耐药率上升显著,米诺环素有所下降;除氨曲南、头孢唑林、头孢替坦和头孢曲松天然耐药外,其它头孢类、氨基糖苷类和喹诺酮类(除左氧氟沙星外)抗菌药物的耐药率大多在70%以上。结论:川东北地区鲍曼不动杆菌分离率有下降趋势,但仍是临床常见致病菌,科室分布广泛,耐药率高,临床治疗应根据药敏结果选择合适的抗菌药物。

Clinical distribution and antibiotic resistance of Acinetobacter baumannii in northeast Sichuan area over three years

Objective:To investigate the clinical distribution and antibiotic resistance characteristics of Acinetobacter baumannii in Northeast Sichuan area over three years and in order to provide reasonable reference for clinical treatment and prevention of Acinetobacter baumannii infection.Methods:A retrospective statistical analysis was performed on the clinical distribution and antibiotics resistance results of all the clinical isolates in our hospital from Jan 2013 to Dec 2015.Results:Acinetobacter baumannii accounted for 2.2%(425),2.0%(342),1.5%(297) respectively among the strains detected in 2013,2014 and 2015.1064 clinical isolated strains of Acinetobacter baumannii were identified during the three years from different kinds of specimens,with 242 (76.2%) from sputum specimens,21(13.8%)from pyogenic fluids.The most prevalent isolates were in the intensive care unit ward (ICU) and neurosurgery department,accounting for 38.1% and 20.9% respectively.Meanwhile,separation rate from surgical department is higher than that from internal medicine department.The resistance showed an increasing trend from 2013 to 2015,and resistance of cefoperazone/sulbactam was remarkably increasing.More than 70% of Acinetobacter baumannii isolates were resistant to Cephalosporins,aminoglycoside and quinolone (except levofloxacin).Conclusion:Although with a decrease tendency of separation rate,Acinetobacter baumannii still is one of the clinical common infections bacteria,with wide distribution and serious drug resistance.It's important to choose proper antibacterial agents according to the results of drug sensitivity.