医院感染鲍曼不动杆菌连续4年耐药性分析

目的了解鲍曼不动杆菌在医院感染中的流行及药敏特征,为临床抗感染治疗提供依据。方法对2001-2004年间某院临床送检标本中分离的439株鲍曼不动杆菌的分布及药敏结果进行回顾性分析。结果鲍曼不动杆菌检出科室分布以重症监护病房构成比最高,为31.66%,其次为移植科23.24%;感染部位以呼吸道和手术切口为主,分别占49.91%和40.82%。鲍曼不动杆菌对阿米卡星、头孢哌酮等12种抗菌药的耐药率逐年升高,对左氧氟沙星、头孢哌酮/舒巴坦、氨苄西林/克拉维酸耐药率无变化,对磷霉素、氨曲南耐药率逐年下降;左氧氟沙星、美罗培南、头孢哌酮/舒巴坦和氨苄西林/舒巴坦耐药率低,可作为抗菌治疗用药。结论鲍曼不动杆菌是目前医院感染重要的条件致病菌,其耐药率呈逐步升高趋势,且多重耐药率高,应引起临床重视。

Analysis of antimicrobial resistance of Acinetobacter baumannii in nosocomial infection during four consecutive years

Objective To realize the prevalence of Acinetobacter baumannii in nosocomial infection(NI) and its characteristics of antimicrobial susceptibility,and provide evidence for clinical anti-infection treatment.Methods Four hundred and thirty-nine strains of Acinetobacter baumannii were isolated from clinical specimens between 2001 and 2004,antimicrobial susceptibility test results were retrospectively analyzed.Results The isolation rate of Acinetobacter baumannii was the highest in intensive care units(31.66%),the next was department of transplantation(23.24%);respiratory tract and surgical incisional wound were the main infection sites,the infection rate was 49.91% and 40.82% respectively;the bacterial resistancet rate to twelve antimicrobial agents(amikacin,cefoperazone and etc) increased every year.There was no change in the resistant rate to levofloxacin cefoperazone/sulbactam and ampicillin/clavulanic,resistant rate to fosfomycin and aztreomam declined;resistance to levofloxacin,meropenem,cefoperazone/sulbactam and ampicillin/sulbactam were low and preferred for antimicrobial treatment.Conclusion Acinetobacter baumannii was the major pathogens in NI at present,resistance to antimicrobial agents have the characteristics of high prevalence and multiple resistance,which should be paid attention during clinical process.