临床鲍曼不动杆菌分布和耐药性分析

目的了解分析我院临床鲍曼不动杆菌分布和耐药性,为医院抗感染治疗及合理使用抗菌药物提供依据。方法采用常规细菌培养方法从临床各种送检标本中分离出细菌,以Micro-Scan auto SCAN4微生物分析系统鉴定菌种并进行体外药物敏感试验。结果 2009年1月～2011年12月三年中我院10183次临床标本中分离出鲍曼不动杆菌178株,检出率存在显著差异(χ2=165.5,P<0.01),且逐年上升;临床科室分布以重症医学科为主,占43.3%,检出科室逐年增多;标本分布以痰(61.2%)为主,标本分布种类逐年上升。除亚胺培南外,鲍曼不动杆菌对14种抗菌药物的耐药率均>60%,且多重耐药(MDR)和广泛耐药(PDR)菌株共占78.6%。三年内广泛耐药株检出率(χ2=13.0,P<0.01)、碳青霉烯类的亚胺培南耐药株检出率(χ2=16.1,P<0.01)差异均有明显统计学意义。结论鲍曼不动杆菌对临床上常用药物耐药十分严重,应加强药敏监测,并建立切实有效的感染控制措施,预防鲍曼不动杆菌在院内传播。

Analysis of the distribution and drug resistance of Acinetobacter Baumannii in recent three years

Objective To understand the distribution and drug resistance of Acinetobacter Baumannii in our hospital and to provide every department with the basis of anti-infective treatment and reasonable antibiotic drug use. Methods Routine culture method was used to isolate and culture Acinetobacter Baumannii, Micro-Scan auto SCAN4 was used to identify and test drug sensitivity. Results A total of 178 strains of Acinetobacter Baumannii were isolated from January 2009 to December 2011, there was significant difference in the surveillance rate which showed a rising situation year by year（χ2=165.5, P 〈 0.01 ）, it was detected mostly at Intensive Care Unit （43.3%）, the unit was increasing year by year; and mostly in sputum （61.2%）, the sample type was increasing year by year. except for Imipenem, the resistance rate of 14 types of antibiotics was all more than 60%, Multi-drug resistant （MDR） and pan-drug resistant （PDR） were accounted for 78,6%. There was significant difference in the surveillance rate of pan-drug and Imipenem resistant Acinetobacter Baumannii. Conclusion The resistance condition of Acinetobacter baumannii in clinic is serious, we should strengthen the monitoring of Acinetobacter baumannii resistance and build the effective control measure to infection to prevent from the spread of the Acinetobacter baumannii in hospital.