连续3年临床分离鲍曼不动杆菌临床分布及耐药性

目的分析某院鲍曼不动杆菌感染现状及耐药性变迁,指导临床用药,为控制医院感染提供相关的科学依据。方法对该院2011年1月—2013年12月临床分离的鲍曼不动杆菌引起的感染分布及药敏检测结果进行回顾性分析。结果 3年共分离鲍曼不动杆菌339株,主要标本来源为痰液,共检出291株,占85.84%;其次尿标本分离29株(8.55%),分泌物标本分离12株(3.54%),血液标本分离3株(0.89%)。主要分布科室为重症监护室(ICU)分离149株(43.95%);其次呼吸内科46株(13.57%),儿科32株(9.44%),肿瘤科22株(6.49%)。鲍曼不动杆菌对妥布霉素、亚胺培南有较好的药物敏感性(耐药率11.11%~49.47%),对其他抗菌药物的耐药率较高;2012年和2013年的耐药率明显低于2011年。结论该院临床分离的鲍曼不动杆菌主要来源于痰标本,多分布于ICU和呼吸科;对抗菌药物耐药率高,但近年有下降趋势。

Clinical distribution and antimicrobial resistance of Acinetobacter bau-mannii isolated from patients in consecutive three years

ObjectiveTo analyze the clinical distribution and antimicrobial resistance of Acinetobacter baumannii (A.baumannii) from a hospital, so as to guide the rational use of antimicrobial agents and provide scientific basis for the prevention and control of healthcare associated infection(HAI). MethodsDistribution and antimicrobial susceptibility testing results of A.baumannii isolated from patients between January  2011 and December 2013 were analyzed retrospectively. ResultsA total of 339 A. baumannii isolates were isolated within three years, 291 isolates (85.84%) were from sputum, followed by urine (n=29,8.55%）, secretion(n=12,3.54%) and blood (n=3, 0.89%). The main distribution departments were intensive care unit(ICU, n=149,43.95%), department of respiratory medicine (n=46,13.57%）, department of pediatrics (n=32,9.44%） and oncology (n=22, 6.49%）. The resistant rate of A.baumannii to tobramycin and  imipenem were 11.11% 49.47%, the resistant rates to the other antimicrobial agents were relatively high; antimicrobial resistant rate of 2012 and 2013 were obviously lower than 2011. ConclusionA. baumannii  from this hospital are mainly from sputum specimens, and mainly distribute in ICU and department of respiratory medicine, antimicrobial resistant rate is high, but there is a decreasing tendency in recent years.