鲍曼不动杆菌临床感染的分布及耐药性分析

目的分析北京儿童医院2006年1月至2008年12月鲍曼不动杆菌的分布及耐药性变迁,以指导临床合理用药。方法对临床送检的12 204份标本中分离的345株鲍曼不动杆菌的分布及耐药性进行回顾性分析。结果3 a鲍曼不动杆菌的分离率分别为2.5%(92/3 636)、2.8%(117/4 056)和3.0%(136/4 512)。345株鲍曼不动杆菌检出科室分布以重症监护病房最高(5.6%),其次为外科(3.6%),呼吸内科(3.4%);阳性标本主要来源于下呼吸道占78.0%(269/345)。3 a间鲍曼不动杆菌对哌拉西林、哌拉西林/他唑巴坦、氨苄西林/舒巴坦、头孢他啶、头孢曲松、头孢吡肟、替卡西林/克拉维酸耐药率呈上升趋势,差别有统计学意义(P<0.05)。对亚胺培南、庆大霉素、阿米卡星、环丙沙星、复方新诺明的耐药率呈上升趋势,但差别无统计学意义(P>0.05)。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的趋势,应引起临床重视。

Distribution and analysis of resistance of Acinetobacter baumannii at clinical infection

Objective To analyze the distribution and resistance of Acinetobacter baumannii at Beijing Children′s Hospital from January 2006 to December 2008,and to guide the rational use of drug in clinical.Methods Three hundred and forty-five strains Acinetobacter baumannii were isolated from 12 204 clinical specimens and it′s distribution and drug resistance then were retrospectively analyzed.Results Acinetobacter baumannii separation rates were 2.5%(92/3 636),2.8%(117/4 056),and 3.0%(136/4 512) in three years.The 345 strains of Acinetobacter baumannii were mainly distributed in department of intensive care unit(5.6%),followed by surgery(3.6%),respiratory medicine(3.4%);The positive samples were mainly from the lower respiratory tract(78.0%,269/345).The resistance rates of Acinetobacter baumannii to piperacillin,piperacillin/tazobactam,ampicillin/sulbactam,ceftazidime,ceftriaxone,cefepime,ticarcillin/clavulanic acid were raised in the three years,and the differences were statistically significant(P<0.05).The resistance rates of Acinetobacter baumannii to imipenem,gentamicin,amikacin,ciprofloxacin,cotrimoxazole were raised also in the three years,but the differences were not statistically significant(P>0.05).Conclusion Acinetobacter baumannii is an important opportunistic pathogen of nosocomial infection and its resistance rate was gradually rising trend,and should pay attention to this condition during clinical process.