内、外科和重症监护病房患者分离的鲍曼不动杆菌耐药率比较

目的:分析内、外科和重症监护病房(ICU)患者分离的鲍曼不动杆菌耐药性,探讨不同来源菌株耐药率间的差别。方法:采用纸片扩散法(K-B法)对2001年内、外科及ICU分离的1083株鲍曼不动杆菌进行分析,用WHONET5软件分析结果;耐药率的显著性比较用x~2检验。结果:2001年共分离鲍曼不动杆菌1314株。其中从内、外科和ICU分离的鲍曼不动杆菌为1083株,占全部鲍曼不动杆菌的82.4％。内科住院患者分离的鲍曼不动杆菌对哌拉西林、头孢噻肟、头孢他啶、头孢吡肟、庆大霉素、阿米卡星、环丙沙星、左氧氟沙星、氨曲南、复方磺胺甲噁唑和氯霉素的耐药率明显低于外科和ICU患者分离的菌株,并有统计学意义(P<0.001);对亚胺培南的耐药率明显低于ICU患者分离菌株(P<0.005)。外科和ICU患者分离的鲍曼不动杆菌之间对哌拉西林、头孢噻肟、头孢他啶、头孢吡肟、阿米卡里、环丙沙星和亚胺培南的耐药率有显著性差异(P<0.01)。结论:调查各科分离的鲍曼不动杆菌对临床常用抗菌药物的耐药率,对临床抗感染治疗的经验用药具有一定的指导意义。

Study on drug resistance of Acinetobacter baumannii isolated from department of medicine, surgery and ICU in hospitals

Objective:To analyze the antimicrobial resistance of Acinetobacter baumannii isolates from departments of medicine, surgery and ICU in hospitals and to explore the differences in antimicrobial resistant rates among them. Methods: Disc diffusion test (K-B method) was adopted to ana-lyze the 1083 isolates of Acinetobacter baumannii from hospitals in 2001 and its results were analyzed statistically by WHONET5. Results: Total 1314 isolates of Acinetobacter baumannii were collected in 2001 and 1083 (82.4% ) of them were collected from departments of medicine,surgery and ICU.The resistance rates of isolates from inpatients in department of medicine resistant to piperacillin, cefo-taxime , ceftzidime, cefepime, gentamicin, amikacin, ciprofloxacin, levofloxacin and trimethoprim/sul-famethoxazole were significantly lower than that of inpatients in departments of surgery and ICU (P < 0.001) .The resistant rates of isolates from inpatients in department of medicine resistant to imipenem were significantly lower than that of inpatients in departments of surgery and ICU ( P < 0.005). There were significant differences in resistant rates among isolates from inpatients of departments of surgery and ICU resistant to piperacillin, cefotaxime, cetazidime, cefepime, amikacin, ciprofloxacin, and imipenem (P<0.01).Conclusion:It is of instructive meahing for empirical uses of anti-infectious agents, to study the resistant rates of Acinetobacter baumannii isolates collected from different departments of hospitals.