214株鲍曼不动杆菌最低抑菌浓度及耐药性

目的　了解我院和威尔斯亲王医院鲍曼不动杆菌对16种抗生素的耐药性。方法　收集我院和香港威尔斯亲王医院临床分离的鲍曼不动杆菌共214株,用琼脂稀释法检测鲍曼不动杆菌对16种抗生素的最低抑菌浓度。结果　214株鲍曼不动杆菌对16种抗菌药物的耐药率中以头孢哌酮舒巴坦、亚胺培南和美罗培南耐药率最低,其他抗菌药物耐药率达49. 5% ~73. 4%。上海菌株对替卡西林、哌拉西林、哌拉西林他唑巴坦、替卡西林克拉维酸、氨苄西林舒巴坦、头孢他啶、头孢吡肟、头孢哌酮、阿米卡星、庆大霉素、环丙沙星、左氧氟沙星和复方磺胺甲口恶唑的耐药率均高于香港菌株。其他抗生素耐药率相似。结论　本院鲍曼不动杆菌耐药性高于香港威尔斯亲王医院,需提醒临床医生慎用抗生素,避免多重耐药鲍曼不动杆菌在院内传播。

Mininal inhibitory concentration and antimicrobial susceptibility for 214 Acinetobacter baumanii strains

Objective To study the resistant rate of Acinetobacter baumannii (A.baumannii) isolates from Shanghai and Hongkong. Methods A total of 214 non-duplicate A.baumannii clinical isolates were collected from Shanghai Renji hospital(n=175) and Hongkong Prince of Wales hospital(n=39).Minimum inhibitory concentrations(MIC) of sixteen antibiotics were determined by agar dilution method. Results Cefoperazone/sulbactam,imipenem and meropenem with low resistance rates were effective drugs against A.baumannii in both cities.The resistance rate of other antibiotics ranged from 49.5% to 73.4%. Shanghai strains had much higher rates of resistance to ticarcillin,piperacillin,pipercillin/tazobactam,ticarcilin/clavulanate,ampicillin/sulbactam,ceftazidime,cefepime,cefoperazone,amikacin,gentamicin,ciprofloxacin,levofloxacin and trimethoprim/sulfamethoxazole than Hongkong strains.The resistance rates to the other antibiotics i.e. cefoperazone/sulbactam,imipenem and meropenem were similar. Conclusions The resistance rates of A. baumannii isolated from Shanghai are much higher than those isolated from Hongkong.A correct antibiotic policy should be addressed at the hospitals to avoid the dissemination of resistant A.baumannii.