呼吸道161株鲍曼不动杆菌的临床分布及耐药性分析

目的了解痰液标本分离的鲍曼不动杆菌的临床分布及对各种常用抗菌药物的耐药情况,为临床合理治疗提供依据。方法从2011年1月至12月广西医科大学第一附属医院患者的痰液标本中分离出161株鲍曼不动杆菌,采用WHONET 5.4软件对数据进行统计分析。结果在161株鲍曼不动杆菌标本中,其临床分布以重症监护病房为主(47.83%),其次为内科(24.23%)和外科(13.04%);鲍曼不动杆菌对常用抗菌药物的耐药率以头孢哌酮/舒巴坦最低(6.21%),其次为亚胺培南/西司他丁及美罗培南(分别为46.58%、47.83%);哌拉西林、哌拉西林/他唑巴坦、头孢他啶、安曲南、庆大霉素、阿米卡星、环丙沙星、左氧氟沙星、复方磺胺甲噁唑及头孢吡肟等的耐药率均在50%以上。结论鲍曼不动杆菌主要分布于各重症监护病房,对多种常见抗生素耐药率有升高趋势,提示临床应加强抗生素的合理应用,防止耐药率进一步增长。

Clinical distribution and drug resistance analysis of 161 strain Acinetobacter baumannii in respiratory tract

Objective To investigate the clinical distribution and the drug resistance to various antibacterials of Acinetobacter baumannii from sputum specimen,and provide reference for the clinical rational therapy.Methods The 161 strain Acinetobacter baumaniis were separated from sputum specimen of patients in the First Affiliated Hospital of Guangxi Medical University from January to December in 2011,and the data were analyzed by WHONET 5.4 software.Results Among the 161 specimens of Acinetobacter baumannii,the dominant clinical distribution was intensive care unit(47.83%)followed by medical department(24.23%)and surgery department(13.04%).The drug resistance rate of Acinetobacter baumanii to cefoperazone/sulbactam was the lowest(6.21%),then was the imipenem/cilastatin(46.58%)and meropenem(47.83%).The drug resistance rates of Acinetobacter baumanii to piperacilli,piperacilli/tazobactam,ceftazidime,atreonam,gentamycin,amikacin,ciprofloxacin,levofloxacin,trimethoprim-sulfamethoxazole and cefepime were all above 50%.Conclusion Acinetobacter baumanii mainly distributes intensive care units,and the drug resistance rates of them show the up tendency,so reasonable application of antibiotic should be enhanced in clinic in order to prevent the increasing of drug resistance rate of Acinetobacter baumannii.