临床分离鲍曼不动杆菌的分布特征及耐药谱变迁

目的研究临床分离鲍曼不动杆菌的分布特征及耐药性的变迁,为临床科学合理使用抗生素提供参考。方法通过回顾性调查方法,对某医院临床标本分离出的鲍曼不动杆菌分布特点和2002-2010年期间该菌耐药性变迁进行分析。结果在调查期间该医院从感染病人的标本中共检出鲍曼不动杆菌2 161株,分离率为4.5%;标本来源以痰液为主,占83.7%。鲍曼不动杆菌感染分布较高的科室是重症监护室、呼吸内科和脑外科;感染部位分布以呼吸道为主。鲍曼不动杆菌对替卡西林、哌拉西林和复方氨苄西林的耐药率最高,并呈逐年上升趋势;对其他类型抗菌药物的耐药率从2002年以来也处于上升趋势。本医院分离的鲍曼不动杆菌对头孢哌酮/舒巴坦和多粘菌素E等抗菌药物都比较敏感。结论该医院2002年以来临床标本鲍曼不动杆菌分离率及其耐药率均呈上升趋势,提示对该菌应加强监测和药敏试验,以便更科学合理使用抗菌药物。

DISTRIBUTION AND TRANSITION OF DRUG RESISTANCE OF Acinetobacter baumannii ISOLATED FROM CLINIC

Objective To investigate the distribution characteristic and the transition of drug resistance of Acinetobacter baumannii and to provide reference for rational use of antibiotics in clinic.Methods The distribution and drug resistance of A.baumannii isolated from various clinical specimens of the infectious patients in a hospital from 2002 to 2010 were analyzed and studied retrospectively.Results A total of 2 161 strains of A.baumannii were isolated during investigation period and the isolation rate was 4.5%.Sputum was the main specimen from which 83.7% strains of A.baumannii were isolated.A.baumannii were mainly distributed at ICU wards,pneumology department and neurosurgery department.The resistance rates to ticarcillin,ticarcillin/clavulanic acid,piperacillin and compound ampicillin were very high and appeared an increasing trend during investigation period.From 2002 the resistance rates to other antibiotics were also increasing year by year.During investigation period,A.baumannii were all sensitive to cefoperazone/sulbactam and polymyxin.Conclusion A.baumannii isolation rate and drug resistance rate are increasing,it is necessary for hospital to strengthen the monitoring of this kind of bacteria and drug sensitive test so as to use the antibiotics scientifically and rationally.