ICU医院获得性鲍氏不动杆菌的临床分布及耐药变迁

目的 了解2009-2010年ICU医院获得性鲍氏不动杆菌(ABA)感染的临床分布及其耐药趋势,为临床感染预防和治疗用药提供参考资料.方法 目标性监测2009-2010年医院感染患者分离出的79株ABA的临床分布,统计分析ABA对16种抗菌药物的耐药率及其变化趋势.结果 79株ABA医院感染标本主要来源于痰液,占59.5％,其次来源于血液或静脉导管,占32.9％；ABA医院感染多见于重症外伤和心脑血管疾病患者,占40.5％、32.9％；ABA对头孢唑林、头孢呋辛钠和头孢呋辛酯的耐药率均为100.0％;对其余12种抗菌药物的耐药率2010年和2009年相比均有不同程度的下降,对庆大霉素、阿米卡星的耐药率显著下降(P＜0.01),对头孢噻肟的耐药率也明显下降,由2009年的82.5％降至2010年的59.0％ (P＜0.05)；ABA对多黏菌素B的敏感性高,2010年和2009年分别为100.0％、80.0％.结论 ICU2010年医院感染ABA的分离率和耐药率较2009年均有下降趋势,已引起科室的重视和关注,但ABA医院感染菌株在ICU仍位居第2位,对大多数抗菌药物亦有较高的耐药性,应继续重视多药耐药菌的预防隔离工作,防止医院感染的发生,合理使用抗菌药物.

Clinical distribution and drug resistance of hospital-acquired Acinetobacter baumanniiin ICU

OBJECTIVE To investigate the clinical distribution of Acinetobacter baumannii infections during 2009-2010 and the trend of the drug resistance so as to provide reference for prevention of the infection and therapeutic use of antibiotics.METHODS Targeted monitoring of 79 strains of A.baumannii isolated from the patients with infections in 2009-2010 was performed,the drug resistance rates of A.baumannii to 16 antibiotics and the development trend of drug resistance were statistically analyzed.RESULTS Among 79 strains of A.baumannii,most were isolated from sputum,accounting for 59.5%,followed by the blood and venous catheter(32.9%);A.baumannii infections were common in the patients with severe trauma and cardiovascular and cerebral diseases,accounting for 40.5% and 32.9%;the drug resistance rates of A.baumannii to cefazolin,cefuroxime,and cefuroxime were 100.0%;as compared with the drug resistance rates to 12 antibiotics in 2009 and 2010,the resistance rates to gentamicin and amikacin significantly decreased(P<0.01),the resistance rate of A.baumannii to cefotaxime significantly decreased from 82.5% in 2009 to 59.0% in 2010(P<0.05).A.baumannii was highly susceptible to polymyxin B,the susceptibility rates were 100.0% and 80.0% in 2010 and 2009,respectively.CONCLUSION As compared with 2010,the isolation rate and drug resistance rate of A.baumannii in 2010 significantly decreased,which has been attached great importance,A.baumannii infection ranks the second place in ICU;A.baumannii is highly resistant to most antibiotics,it is necessary to further strengthen the prevention and isolation of multidrug-resistant bacteria and reasonably use antibiotics so as to prevent nosocomial infections.