Cox-Staurt趋势检验分析医院感染鲍曼不动杆菌耐药趋势

目的了解医院感染鲍曼不动杆菌流行病学特征和耐药性变化趋势。方法采用Vitek2 COMPACT自动化微生物分析系统对2008—2010年医院感染患者送检的标本进行细菌鉴定和药敏试验,Cox-Staurt趋势检验分析医院感染鲍曼不动杆菌耐药趋势。结果共分离出医院感染鲍曼不动杆菌230株,分离率为14.90%,呈上升趋势,主要来源于痰标本,占83.04%。分布在23个临床科室,其中重症医学科检出最多,占28.26%,对阿米卡星的总耐药率最低,为5.08%,对其余抗菌药物的总耐药率均大于40%,其中呋喃妥因、头孢替坦、氨曲南、头孢曲松、头孢唑啉、氨苄西林的总耐药率>85%。经Cox-Staurt趋势检验分析,对哌拉西林/他唑巴坦、亚胺培南、左旋氧氟沙星、妥布霉素、氨苄西林/舒巴坦、头孢吡肟、庆大霉素、环丙沙星、复方磺胺甲噁唑、哌拉西林的耐药率呈上升趋势,而对氨曲南、头孢替坦、头孢唑啉、氨苄西林、呋喃妥因、头孢他啶、头孢曲松、阿米卡星的耐药率无变化趋势。结论医院感染鲍曼不动杆菌分离率越来越高,对多种抗菌药物耐药,且耐药率多呈上升趋势,应加强细菌耐药性监测和抗菌谱分析,以指导临床合理用药。

Drug Resistance Tendency of Acinetobacter Baumannii Isolated from Nosocomial Infection Patients by Cox-Staurt Trend Test

Objective To study the epidemiologic feature and drug resistance tendency of Acinetobacter baumannii isolated from patients with nosocomial infection.Methods The specimens of nosocomial infection patients from 2008 to 2010 were examined with Vitek2 COMPACT auto-microbial analysis system for bacteria identification and antimicrobial resistance test,and the drug resistance tendency was analyzed by Cox-Staurt trend test.Results There were 230 strains of Acinetobacter baumannii isolated from nosocomial infection patients.The isolating rate was 14.90%,and it was in an increasing trend.They were detected mostly from sputum specimens,amounting for 83.04%.They came from 23 clinical departments,especially intensive care units amounting for 28.26%.The resistant rate of Acinetobacter baumannii to Amikacin was 5.08%,being the lowest.The resistant rates of Acinetobacter baumannii to other antibiotics were more than 40%,among which the resistant rates of Acinetobacter baumannii to Nitrofurantoin,Cefotetan,Aztreonam,Ceftriaxone,Cefazolin and Ampicillin were more than 85%.The Cox-Staurt trend test showed that the resistant rates were in an increasing tendency for Piperacillin/Tazobactam,Imipenem,Levofloxacin,Tobramycin,Ampicillin/Sulbactam,Cefepime,Gentamicin,Ciprofloxacin,Sulfamethoxazole/Trimethoprim,Piperacillin,but the resistant rates had no changing trend for Aztreonam,Cefotetan,Cefazolin,Ampicillin,Nitrofurantoin,Ceftazidime,Ceftriaxone and Amikacin.Conclusion The isolating rate of Acinetobacter baumannii isolated from nosocomial infection patients becomes more and more high,with a multidrug resistance and an increasing tendency of their resistant rates.So it is necessary enhance the bacterial resistance surveillance and antibiogramic research to guide rational drug therapy.