2011—2017年河南中医药大学第三附属医院心血管科鲍曼不动杆菌的分布及耐药性分析

目的 探讨河南中医药大学第三附属医院心血管疾病住院患者鲍曼不动杆菌感染的分布及耐药情况，为临床治疗提供指导性意见。方法 选取河南中医药大学第三附属医院心血管内科2011年1月—2017年12月确诊的医院感染性鲍曼不动杆菌患者103例，统计分析发生感染患者的疾病分布、标本来源及其耐药情况。结果 共分离出103株鲍曼不动杆菌，其中住院患者原患疾病主要为急性心肌梗死（43.69%）和冠心病(20.39%)；标本来源依次为晨痰及下呼吸道分泌物、胸水、血液、尿液；鲍曼不动杆菌对磺胺甲（口恶）唑/甲氧苄啶、奈替米星的耐药率均在60%以上，对头孢他啶、环丙沙星的耐药率均在50%以上；对阿米卡星、美罗培南、亚胺培南、米诺环素的耐药率均在20%～30%。结论 鲍曼不动杆菌对阿米卡星、美罗培南、亚胺培南、米诺环素的耐药率相对较低，临床上应根据药敏结果合理用药。

Analysis on distribution and drug resistance of Acinetobacter baumannii in Department of Cardiovascular of Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from 2011 to 2017

Objective To investigate the distribution and drug resistance of Acinetobacter baumannii infection in hospitalized patients with cardiovascular diseases in Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, and provide guidance for clinical treatment. Methods Patients (103 cases) with hospital-infected A. baumannii in Department of Cardiovascular of Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2011 to December 2017 were selected, and the distribution of infected patients, the source of specimens, and drug-resistance situation were analyzed. Results A total of 103 strains of A. baumannii were isolated. The main original disease of inpatients were acute myocardial infarction (43.69%) and coronary heart disease (20.39%). Specimens source of A. baumannii were followed by morning and lower respiratory secretions, pleural effusion, blood, and urine. The resistance rates of A. baumannii against azole/methoxyoxidine and netilmicin were all above 60%, and the resistance rates against ceftazidime and ciprofloxacin were more than 50%. The resistance rates of A. baumannii against amikacin, meropenem, imipenem, and minocycline were 20% - 30%. Conclusion The resistance rate of A. baumannii against amikacin, meropenem, imipenem, and minocycline is relatively lower, and rational drug use should be made according to the results of drug sensitivity.