307例鲍氏不动杆菌的临床分布与耐药性分析

摘要

目的：了解分析鲍氏不动杆菌感染的临床分布特点及对各种抗菌药物的耐药性，为临床合理应用抗菌药物及治疗提供科学的依据。方法：回顾性调查2014年1-12月确诊为鲍氏不动杆菌感染的病例，按照全国临床检验规程进行分离，并采用美国临床实验室标准化研究所（CLSI）推荐的K-B法进行药敏试验。结果：共分离出307株鲍氏不动杆菌，来自临床送检的各类标本，以痰标本分离率最高，占90.55%，其次分别是清洁中段尿、分泌物，分别占6.84%、1.63%；鲍氏不动杆菌对米诺环素、头孢哌酮/舒巴坦、美罗培南的耐药率较低，分别为3.91%、5.86%、7.17%；307株鲍氏不动杆菌主要分布于内科系统，其中呼吸内科90株，占29.32%；其次是神经内科62株，占20.20%；老年病科56株，占18.24%；ICU50株，占16.29%；胸外科34株，占11.07%；其他15株，占4.89%。结论：鲍氏不动杆菌是医院感染的常见致病菌之一，应加强鲍氏不动杆菌的耐药性监测，把握其耐药趋势，纠正不合理使用抗生素现象，积极采取有效的控制措施，避免出现泛耐药的超级细菌。%Objective:To understand and analyze the clinical distribution and drug resistance of acinetobacter baumannii in order to provide scientific basis for the clinical rational use of antibacterial drugs and treatment.Method:The cases who were diagnosed with infection of acinetobacter baumannii from January 2014 to December 2014 were investigated retrospectively.The bacteria was separated according to the national clinical inspection procedures.K-B method recommended by American clinical laboratory standardization institute(CLSI) was used for drug sensitive test.Result:A total of 307 strains of acinetobacter baumannii were isolated.They were from all kinds of clinical specimens,the separation rate of the sputum specimen was the highest,accounted for 90.55%,the following was clean midstream urine and secretion,accounted for 6.84% and 1.63% respectively. The drug resistance rates of acinetobacter baumannii to Minocycline,Cefoperazone/Sulbactam,Meropenem were lower,accounted for 3.91%,5.86% and 7.17% respectively.307 strains of acinetobacter baumannii were mainly distributed in the internal medical system,including respiratory medicine 90 strains,accounted for 29.32%,followed by neurology 62 strains(20.20%),geriatrics department 56 strains(18.24%),ICU 50 strains(16.29%),thoracic surgery 34 strains(11.07%),other departments 15 strains(4.89%). Conclusion:Acinetobacter baumannii is one of the common pathogenic bacteria of hospital infection.We shall strengthen the monitoring of drug resistance of acinetobacter baumannii,grasp its trend of drug resistance,correct the phenomenon of irrational use of antibiotics,actively take effective control measures and avoid the incidence of superbugs with generic drug resistant.