鲍曼不动杆菌的临床分布及耐药情况分析

目的：了解高邮市人民医院鲍曼不动杆菌的临床分布状况及耐药情况，为有效预防和控制医院感染、指导临床合理用药提供理论依据。方法对2010-2012年我院临床分离的鲍曼不动杆菌进行鉴定，采用纸片扩散法进行药敏试验，采用 WHONET 5．6软件对数据进行统计分析鲍曼不动杆菌的科室分布情况与耐药率及变化趋势。结果3年共分离出155株鲍曼不动杆菌，主要分离来自痰液（82．6％），其次为分泌物及脓汁（12．3％）；科室分布以 ICU （34．2％）为主，其次是神经外科（18．1％）和呼吸内科（15．5％）；3年来鲍曼不动杆菌总体耐药率呈现上升趋势，尤其以亚胺培南最为明显，亚胺培南3年的耐药率分别是23．3％，44．2％和68．3％；临床常用抗菌药物中只有头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率低于40％，其余均大于65％。结论鲍曼不动杆菌是医院感染中重要的条件致病菌，且耐药率较高，临床医务人员应根据药敏结果合理选择抗菌药物，控制耐药菌株的流行及医院感染。

Analysis of Clinical Distribution and Drug Resistance of Acinetobacter baumannii

Objective To analyze of Clinical Distribution and Drug Resistance of Acinetobacter baumannii （AB）in Gaoyou People’s Hospital,and to prevention and control of healthcare-associated infection,and provide theoretical basis to selection of clinical drugs.Methods The isolated of AB strains from 2010 to 2012 in our hospital were identified and antimicrobial susceptibility tests were performed using the K-B method,and thus,the ward distribution and the drug re-sistance rates and the changing trend were respectively analyzed by WHONET 5.6 software.Results A total of 155 AB strains were isolated in 3 years,in which the most common specimens were sputum（82.6%）,followed by secretions and pus（12.3%）.When it came to the ward distribution,ICU was the primary,which accounted for 34.2%,followed by the department of neurosurgery （18.1%）and respiratory medicine（15.5%）.There was a obviously increasing over-all trend in drug resistance rates from 2011 to 2013,while imipenem was especially obvious,in which the drug resistance rates of imipenem were 3.3%,44.2% and 68.3% in 3 years.The drug resistance rates of the most commonly used an-tibiotics were more than 65%,only Cefoperazone/Sulbactam and Piperacllin/ Tazobactam below 40%.Conclusion Acinetobacter baumannii is the major opportunistic pathogenic bacteria in nosocomial infection,and drug resisance rate is higher.Clinicians should rationally choose antibacterials according to susceptibility test results,in order to control the epidemic of the drug resistance strains and healthcare-associated infection.