神经外科病房404株鲍曼不动杆菌的耐药性分析

目的了解2011~2014年从川北医学院附属医院神经外科病房送检标本中分离的鲍曼不动杆菌的标本来源和耐药状况,为临床治疗和医院感染控制提供依据。方法对404株非重复鲍曼不动杆菌的临床分布和抗菌药物敏感性资料进行回顾性分析。结果从神经外科患者标本中分离的鲍曼不动杆菌89.1%来自痰液,7.9%来自脑脊液。鲍曼不动杆菌对米诺环素和头孢哌酮/舒巴坦的耐药率最低,分别为28.6%和31.8%;对亚胺培南、美罗培南的耐药率分别为79.4%、83.2%;对其他监测的抗菌药物的耐药率均超过了69.0%。结论来源于神经外科的鲍曼不动杆菌对多种抗菌药物耐药率很高,米诺环素和头孢哌酮/舒巴坦对鲍曼不动杆菌仍具有较好的体外抗菌活性。临床应加强抗菌药物的管理,提高药敏试验率并合理使用抗菌药物。

Analysis on drug resistance in 404 strains of Acinetobacter Baumannii isolated from Neurosurgery wards

Objective To investigate the specimen source and drug resistance in the strains of Acinetobacter baumannii isolated from the submitted samples in the neurosurgery wards of our hospital during 2011-2014 in order to provide the reference for clini‐cal treatment and nosocomial infection control .Methods A retrospective analysis was performed on the clinical data of clinical dis‐tribution and antibacterial drugs sensitivity in 404 non‐repeated strains of Acinetobacter baumannii isolated from the samples of neurosurgical patients .Results The mainly specimen source of Acinetobacter baumannii isolated from neurosurgical patients was sputum and cerebrospinal fluid ,accounting for 89 .1% and 7 .9% respectively .Acinetobacter baumannii isolates showed the lowest resistance rates to minocycline and cefoperazone/sulbactam (28 .6% and 31 .8% respectively) .The resistance rates to imipenem and meropenem were 79 .4% and 83 .2% respectively ;the resistance rate to other antibacterial drugs exceeded 69 .0% .Conclusion Acinetobacter baumanii strains isolated from the neurosurgery department have higher resistance rates to many kinds of antibacteri‐al agents ,minocycline and cefoperazone/sulbactam still has good in vitro antibacterial activity against Acinetobacter baumanii .Clinic should strengthen the management of antibacterial agents ,increases the rate of drug susceptibility test and rationally uses the anti‐bacterial drugs .