2013—2016年老年病医院鲍曼不动杆菌临床分布及耐药性

目的了解2013—2016年某老年病医院鲍曼不动杆菌（AB）临床分布及耐药性变化趋势。方法采用回顾性研究对2013—2016年全院患者分离的AB标本来源、科室分布和耐药性进行分析。结果2013—2016年共分离1 712株AB，2013、2014、2015、2016年AB分离率逐年下降，分别为17.92%、17.17%、15.10%、11.81%；AB标本来源主要为痰（1 524株，89.02%），其次为尿（79株，4.61%）和血（37株，2.16%）。检出AB居前3位的科室依次为重症监护病房（798株，46.61%）、呼吸内科（507株，29.62%）、神经内科（156株，9.11%）。2013—2016年AB对绝大部分抗菌药物耐药率不断上升，对复方磺胺甲口恶唑的耐药率（25.68%～65.89%）较低，其次为头孢哌酮/舒巴坦（54.74%～68.00%），对亚胺培南的耐药率为71.40%～77.42%,对其余药物的耐药率均＞60%；2013—2016年AB对头孢吡肟、头孢哌酮/舒巴坦、庆大霉素、妥布霉素、复方磺胺甲口恶唑的耐药率比较，差异有统计学意义（均P＜0.05）。结论该院AB耐药率不断升高，需加强监测，促进抗菌药物合理使用，阻断AB的医院感染和传播。

Distribution and antimicrobial resistance of Acinetobacter baumannii in a geriatric hospital from 2013 to 2016

ObjectiveTo analyze the clinical distribution and antimicrobial resistance change trend of Acinetobacter baumannii（AB） from a geriatric hospital in 2013-2016. MethodsSpecimen source, department distribution, and antimicrobial resistance of AB isolated from all patients in the hospital from 2013 to 2016 were analyzed retrospectively. ResultsFrom 2013 to 2016, 1 712 strains of AB were isolated, AB isolation rates in 2013, 2014, 2015, and 2016 decreased year by year, which were 17.92%, 17.17%, 15.10%, and 11.81%, respectively. AB were mainly isolated from sputum (n=1 524, 89.02%), followed by urine (n=79, 4.61%) and blood (n=37, 2.16%). The main departments of AB isolation were intensive care unit (n=798, 46.61%), department of respiratory medicine (n=507, 29.62%), and neurology department (n=156, 9.11%). Resistance rates of AB to most antimicrobial agents increased in 2013-2016, resistance rates to compound sulfamethoxazole were low (25.68%-65.89%), followed by resistance rates to cefoperazone/sulbactam (54.74%- 68.00%), resistance rates to imipenem were 71.40%-77.42%, to the other antimicrobial agents were all>60%; in 2013-2016, resistance rates of AB to cefepime, cefoperazone /sulbactam, gentamicin, tobramycin, and compound sulfamethoxazole were significantly different (all P<0.05). ConclusionAntimicrobial resistance rates of AB in this hospital is increasing, it is necessary to strengthen the monitoring, promote the rational use of antimicrobial agents, and block the infection and transmission of AB in hospital.