福建医科大学附属第一医院2008—2010年鲍曼不动杆菌耐药性分析

目的了解福建医科大学附属第一医院2008—2010年临床分离鲍曼不动杆菌对各类抗菌药物的耐药性,以指导临床规范用药及防止耐药性增加。方法按统一方案、采用统一的材料、方法和判断标准(CLSI 2010年版)进行鲍曼不动杆菌耐药性监测(头孢哌酮-舒巴坦采用K-B制片法)。结果该院2008—2010年住院患者鲍曼不动杆菌临床分离株共923株,最常见的分离部位为下呼吸道;鲍曼不动杆菌主要来源于ICU和神经外科、神经内科患者,该菌对米诺环素、阿米卡星耐药率低;2009—2010年分离菌对头孢哌酮-舒巴坦的耐药率比2008年下降,差异有统计学意义;2009—2010年对美罗培南、亚胺培南、妥布霉素、甲氧苄啶-磺胺甲口恶唑、哌拉西林-他唑巴坦、替卡西林-克拉维酸、头孢曲松、头孢吡肟和左氧氟沙星耐药率比2008年显著升高,差异有统计学意义;其中对美罗培南的耐药率逐年升高达59.2%;对亚胺培南的耐药率2009年64.7%,2010年为57.9%,差异有统计学意义。结论鲍曼不动杆菌对多种抗菌药物耐药率高,应加强鲍曼不动杆菌耐药性监测,隔离鲍曼不动杆菌感染者,防止医院内传播。

Antibiotic resistance ananlysis of Acinetobacter baumannii strains isolated during 2008 and 2010 in the First Affiliated Hospital of Fujian Medical University

Objective To investigate the antibiotic resistance of Acinetobacter baumannii strains collected in our hospital during 2008 and 2010 for rational antimicrobial therapy. Methods All the strains were isolated from patients during the period from January 2008 to December 2010. Susceptibility testing was carryied out by means of a unified protocol. Results were analyzed according to CLSI 2010 standards. Results The 923 strains of A. baumannii were primarily isolated from lower respiratory secretions, and mainly from department of intensive care unit, neurosurgery or neurology. These strains showed relatively lower resistance rate to minocycline and amikacin. During 2009 and 2010, the percentage of the strains resistant to cefperazone-sulbactam was significantly lower than that in 2008. However, the resistance rate to meropenem, imipenem, tobramycin, sulfamethoxazole-trimethoprim, piperacillin-tazobactam, ticarcil- lin-clavulanic acid, ceftriaxone, cefepime, or levofloxacin was significantly higher than that in 2008. It is noteworthy that the percentage of the strains resistant to meropenem rised gradually to 59.2% during the 3-year period. The percentage of the strains resistant to imipenem increased to 64. 7% during 2009 and decreased significantly to 57. 9% during 2010. Conclusions The A. baumannii strains isolated during 2008 and 2010 were highly resistant to a variety of antibiotics. It is essential to strengthen the sterilization and insulation measures and make reasonable use of antibiotics.