127株不动杆菌属细菌科室分布及药敏分析

目的了解本院不动杆菌属细菌的科室分布及耐药性情况,指导临床合理使用抗菌药物。方法对本院2008年2月～2010年10月全院送检的2688例痰标本分离出的127株不动杆菌属细菌进行药敏分析,并比较主要检出鲍曼不动杆菌科室的分布及药敏结果。结果 2688例痰标本共检出鲍曼不动杆菌119株,洛菲不动杆菌8株,检出率分别为4.4%和0.3%。鲍曼不动杆菌对14种常用的抗生素普遍耐药,平均耐药率高达80.9%,仅对头孢哌酮/舒巴坦表现出敏感,敏感率为65.5%,耐药率19.4%;而洛菲不动杆菌耐药率较低,平均耐药率为22.1%。鲍曼不动杆菌主要检出科室为:ICU、神经外科、神经内科、呼吸内科,这些科室的多重耐药株、泛耐药株例数显著高于其他科室(P﹤0.05),各科室多重耐药株、泛耐药株构成比分别为67.4%、30.4%;81.3%、18.7%;77.7%、16.6%;42.8%、21.4%;23.8%、4.7%。结论痰液标本中分离的不动杆菌属菌株主要以鲍曼不动杆菌为主,随着抗生素的广泛应用,抗生素的敏感性发生了巨大变化,其中多重耐药株(MDR-Ab)、泛耐药株(PDR-Ab)占有很高的比例,临床已经面临无药可治的局面,加强鲍曼不动杆菌耐药机制的深入研究和新药的开发,以控制院内感染的蔓延刻不容缓。

Analysis on distribution and antibiotic susceptibility of 127 Strains Acinetobacter

OBJECTIVE This present study investigated the antibiotic susceptibility and distribution of Acinetobacter in different departments,so as to guide rational prescribing of antibiotics in clinical practice. METHODS From Feb 2008 to Oct 2010,127 Acinetobacter strains were identified from 2688 sputum specimens,and the antibiotic susceptibility and department distribution of Acinetobacter were determined. RESULTS Acinetobacter baumannii was identified in 119 patients and Acinetobacter lwoffi in 8 patients,with a detection rate of 4.4% and 0.3%,respectively. Acinetobacter baumannii was resistant to 14 common antibiotics(mean drug resistance rate:80.9%),and only sensitive to cefoperazone/sulbactam(sensitivity rate:65.5%;drug resistance rate:19.4%). However,Acinetobacter lwoffi had a low drug resistance rate(22.1%). Acinetobacter baumannii was mainly found in the Intensive Care Unit(ICU),and Department of Neurosurgery,Neurology and Respiratory which had higher proportions of multi-drug resistant strains and pan-resistant strains than other departments(P﹤0.05). The proportion of multi-drug resistant strains and pan-resistant strains in these departments were 67.4% and 30.4%,81.3% and 18.7%,77.7% and 16.6%,42.8% and 21.4%,and 23.8% and 4.7%,respectively. CONCLUSION Acinetobacter baumannii was the dominant species in Acinetobacter. With the wide application of antibiotics,the antibiotic susceptibility of Acinetobacter was significantly changed. Currently,multi-drug resistant strains and pan-resistant strains account for a high proportion of Acinetobacter. Therefore,it is necessary to investigate the mechanisms underlying the drug resistance and develop novel drugs which may be beneficial for the control of nosocomial infection.