鲍曼不动杆菌耐药性变化与抗生素使用频度分析

目的:分析我院2007–2009年鲍曼不动杆菌分离及耐药性变化和常用抗菌药使用频度。方法:采用API鉴定细菌,K-B纸片扩散法测定抗菌药物敏感性,WHONET 5.4软件进行数据分析;采用世界卫生组织推荐的限定日剂量(DDD)法分析常用抗菌药物的用药频度。结果:我院2007–2009年鲍曼不动杆菌的临床分离率由4.26%上升至5.10%;鲍曼不动杆菌对多种常用抗菌药物的耐药率有不同程度的上升,其中,头孢菌素类耐药率增幅最大,头孢呋辛由25.18%上升到81.15%,亚胺培南由11.37%上升到29.11%;抗菌药物的总DDDs逐年增加,12种常用抗菌药物中头孢菌素类的年总DDDs值增长了34.30%,以一代头孢增长最高为143.75%;碳青霉烯类增长了63.33%;单环β-内酰胺酶抑制剂复合物比2007年增长了61.78%;喹诺酮类药物中左氧氟沙星DDDs呈负增长,2009年下降最多为29.98%。结论:除头孢呋辛、头孢哌酮/舒巴坦、亚胺培南/西司他丁外,鲍曼不动杆菌对其他常用抗菌药物耐药率呈上升趋势。

Analysis ofAcinetobacter baumannii resistance and DDDs of antibacterial drugs used commonly

Objective： To analyze the isolation and drug resistance of Acinetobacter baumannii and the frequency of commonly used antibacterial agents from 2007 – 2009.Methods： The API was used for identification of bacteria,K-B disk diffusion method was applied for determining susceptibility to antimicrobial agents,WHONET 5.4 software was used for data analysis;the frequency of commonly used antibacterials was analyzed by the defi ned daily dose（DDD） method recommended by the WHO.Results： The clinical isolating rate of Acinetobacter baumannii increased from 4.26% to 5.10% in 2007 – 2009 in our hospital.The resistance rates of Acinetobacter baumannii to multiple antibacterials increased to varying degrees,the resistance rates to cephalosporins increased most,the resistance rate to cefuroxime increased from 25.18% to 81.15%,the imipenem resistance rate raised from 11.37% to 29.11%.The total DDDs of antimicrobials increased year by year.In 12 kinds of commonly used antimicrobials,the total DDDs of cephalosporins increased by 34.30% per year,and the growth rate of the first generation of cephalosporins was the most（143.75%）;the DDDs of carbapenems increased by 63.33%;the DDDs of simple ring beta-lactamase inhibitor compound increased 61.78% than that of in 2007;the DDDs of levo？ oxacin had a negative growth with the decrease rate of 29.98% in 2009.Conclusion： In addition to cefuroxime,cefoperazone/sulbactam and imipenem/cilastatin,the resistance rates of Acinetobacter baumannii to other antimicrobial drugs showed an ascendant trend.