2010年住院患者鲍曼不动杆菌的耐药性分析

目的了解我院住院患者的鲍曼不动杆菌的分布特点及耐药情况,为临床治疗提供可靠依据。方法采用法国生物梅里埃公司VITEK 2 Compact系统进行细菌鉴定,K-B法进行药敏试验,使用WHONET 5.4软件进行细菌的耐药性分析。结果我院鲍曼不动杆菌检出率为6.62%,出现最多是痰标本,占81.16%;鲍曼不动杆菌感染主要以康复科、神经科及ICU最多,其次为呼吸内科。该菌对头孢哌酮/舒巴坦和米诺环素的敏感性最高,均在80%以上,对美洛培南和亚胺培南的敏感率均在60%以上,对其它抗菌药物的耐药率在50%以上。结论鲍曼不动杆菌是医院感染重要的条件致病菌,其对抗生素耐药率高,且多重耐药,美洛培南和亚胺培南是首选的经验性治疗鲍曼不动杆菌的药物,头孢哌酮/舒巴坦和米诺环素是治疗鲍曼不动杆菌最敏感的抗菌药物,对于多重耐药鲍曼不动杆（MDR-AB）感染,可采用头孢哌酮/舒巴坦和米诺环素联合治疗方案。

Drug resistance analysis of acinetobacter baumanii from inpatients in 2010

OBJECTIVE To study the distribution and the drug resistance of Acinetobacter baumanii from inpatients of our hospital,providing laboratory evidences for clinical treatment.METHODS Acinetobacter baumannii was identified by VITEK 2 Compact(bioMérieux Corporate) and susceptibility was determined by Kirby-Bauer method.The resistance rates were analyzed by WHONET 5.4 software.RESULTS The isolating rate of Acinetobacter baumanii was 6.62%,of which,81.16% were noted in sputum specimen.Acinetobacter baumanii infection mainly in rehabilitation department,neurology and ICU the most,followed by respiratory medicine.Acinetobacter baumanii were highly sensitive to cefoperazone/sulbactam and minocycline,with susceptible rates of both exceeding 80%,and which were also sensitive to imipenem and meropenem,with susceptible rates exceeding 60%,the other drugs with antibiotic resistance rate exceeding 50%.CONCLUSION Acinetobacter baumanii are the predominant opportunistic pathogenic bacteria in nosocomial infection,which are highly resistant and multiresistant to antibiotics.Meropenem and imipenem are the preferred empirical antibacterial therapy for Acinetobacter baumannii,cefoperazone/sulbactam and minocycline are the most susceptible antibacterial drug for Acinetobacter baumanii,infection with Multi-Drug Resistant Acinetobacter baumannii(MDR-AB),using cefoperazone/sulbactam and minocycline treatment combinations.