2009～2013年我院鲍曼不动杆菌耐药性监测

目的：分析我院临床分离的鲍曼不动杆菌的耐药性变迁情况,为控制医院感染及合理用药提供依据。方法：采用Microscan Auto-scan-4微生物分析仪对细菌作鉴定,药敏试验判断参照2009年CLSI指南,对2009-2013年分离的鲍曼不动杆菌耐药性进行回顾性分析。结果：2009-2013年共分离出鲍曼不动杆菌1 094株,重症医学病区（ICU）388株（35.5%）,以痰液分离最多523株（47.8%）。多重耐药鲍曼不动杆菌分离率为56.0%,泛耐药鲍曼不动菌分离率为16.3%,耐碳青霉烯类鲍曼不动杆菌分离率为31.9%,其检出率呈现逐年上升的趋势。鲍曼不动杆菌药敏结果显示,没有耐药率〈10%的抗菌药,头孢哌酮/舒巴坦的耐药率较低18.6%,对其他抗菌药,包括三、四代头孢菌素、喹诺酮类、亚胺培南等耐药率均〉70%。结论：鲍曼不动杆菌极易对抗菌药产生耐药,医院应在药敏的指导下合理选用抗菌药,减缓耐药菌株的产生及感染的暴发流行。

Surveillance on Drug Resistance of Acinetobacter Baumannii Between 2009-2013

Objective：To analyze the changes of drug resistance of Acinetobacter baumannii in the hospital to provide theory basis for controling the prevalence of nosocomial infections and rational use of antibioties. Methods：The identification and drug susceptibility testing of the bacteria were implemented by using Microscan Autoscan-4 Microbial Analyzer from America. The drug sensitivity test was carried out according to CLSI2009. The drug resistance of baumanii abstracted between 2009 and 2013 was reviewed. Results：A total number of 1 094 strains of Acinetobacter baumannii was abstracted between 2009 and 2013. 388 strains mainly from ICU accounted for 35. 5%,and 523 strains mostly from sputum accounted for 47. 8%. The detection rate of multidrug-resistant Acinetobacter baumannii was 56. 0% with 16. 3% of Pan-resistant Acinetobacter baumannii and 31. 9% of Carbapenem-resistant Acinetobacter Baumannii. And the detection rates were increasing every year. The drug sensitivity test of Acinetobacter baumannii showed that there were no antibiotics with the drug resistance of less than 10%. Cefoperazone sulbactam with 18. 6% of drug resistance and the third and fourth generation cephalosporins,Fluoroquinolones,and imipenem were of more than 70% drug resistance. Conclusion：The Acinetobacter baumannii was highly resistant to antibiotics. Rational application of antibiotics should be implemented according to the drug sensitivity test in order to reduce the production of drug-resistance bacteria and the prevalence of infection.