基层医院10年鲍曼不动杆菌分布特点及耐药性变迁分析

目的分析基层医院2005~2014年鲍曼不动杆菌分布特征及耐药性变迁趋势,为临床合理用药提供参考。方法回顾性分析基层医院10年临床分离鲍曼不动杆菌感染特征,分析鲍曼不动杆菌对10种常见抗菌药物的耐药性。结果 2005~2014年,共分离鲍曼不动杆菌576株,占所有革兰阴性菌31.44%,明显高于大肠埃希菌、铜绿假单胞菌、肺炎克雷伯杆菌(P0.05);主要来自痰标本446株(77.43%)、重症监护室290株(50.35%);其中头孢哌酮/舒巴坦(CSL)耐药率44.44%,米诺环素(MIN)耐药率62.24%,亚胺培南(IPM)、美洛培南(MEM)等8种抗菌药物耐药率均超过70.00%;亚胺培南(IPM)、头孢他啶(CAZ)、复方磺胺甲噁唑(SXT)呈逐年下降趋势,美洛培南(MEM)、阿米卡星(AMK)、左氧氟沙星(LEV)、米诺环素(MIN)呈逐年上升趋势。结论基层医院鲍曼不动杆菌分离株数逐年升高,且对常用抗菌药物普遍耐药,应加强对呼吸道感染、重症监护室患者的护理与监控,临床医生应根据实验室药敏试验合理选用抗菌药物,以预防鲍曼不动杆菌感染的发生。

Analysis of distribution characteristics and drug resistance change of acinetobacter baumannii in primary hospital during 10 years

Objective To analyze the distribution characteristics and drug resistance change of acinetobacter baumannii in prima‐ry hospital during 2005-2014 to provide reference for clinical rational drug use .Methods The infection characteristics of acineto‐bacter baumannii in primary hospital during 10 years and its resistance to 10 kinds of common antibacterial drugs was analyzed .Re‐sults A total of 576 strains of acinetobacter baumannii were isolated during 2005-2014 ,accounting for 31 .44% of all Gram nega‐tive bacteria ,which was significantly higher than that of Escherichia coli ,pseudomonas aeruginosa and klebsiella pneumonia bacillus (P<0 .05);446 strains were mainly originated from the sputum specimens (77 .43% ) and 290 strains(50 .35% ) from ICU ;the re‐sistant rate was 44 .44% for CSL ,62 .24% for MIN and more than 70 .00% for 8 kinds of antibacterial drugs of IPM ,MEM ,etc .;which to IPM ,CAZ ,SXT showed the declining trend year by year ,while which to MEM ,AMK ,LEV ,MIN showed the rising trend year by year .Conclusion The isolated acinetobacter baumannii strains in primary hospital are rised year by year ,and generally have resistance to commonly used antibacterial drugs ,the clinical doctors should rationally select antibacterial drugs according to the drug susceptibility test results for preventing the occurrence of acinetobacter baumannii infection .