2012-2016年湖州市妇幼保健院鲍曼不动杆菌的耐药性分析及临床分布

摘要

目的 动态监测近年鲍曼不动杆菌的分布和对临床常用抗生素耐药的情况,为控制院内感染提供理论依据.方法 采用WHONET5.6对2012年1月至2016年12月湖州市妇幼保健院临床分离的鲍曼不动杆菌的来源,在医院各科室的分布情况及该菌对哌啦西林/他唑巴坦等17种抗生素的耐药性进行分析. 结果 2012-2016年分离的280株鲍曼不动杆菌主要来源于呼吸道(64.29％)和尿液(21.43％);对氨苄西林/舒巴坦、哌啦西林/他唑巴坦、阿米卡星、左氧氟沙星未出现耐药;对氨苄西林、氨曲南、头孢曲松、头孢替坦、头孢唑林的耐药率高达96.00％.对头孢他啶、头孢吡肟、亚胺培南的耐药率分别为20.36％、8.93％、2.14％.结论 鲍曼不动杆菌主要引起呼吸道和泌尿系统感染,多数常用抗生素的耐药率低于文献报道,青霉素加酶抑制剂可作为治疗首选.应加强细菌耐药性监测,依据药敏结果合理使用抗生素,严格判断目标菌和定植菌,以减缓耐药菌株产生和传播.%Objective To analyze the distribution and drug resistances of clinical isolates of Acinetobacter baumannii in Huzhou Maternal and Child Hospital from 2012 to 2016.Methods Total 140 strains of Acinetobacter baumannii were collected in our hospital from January 2012 to December 2016.The distribution and drug resistance to 17 antibiotics were analyzed by WHONET 5.6.Results Among 140 Acinetobacter baumannii isolates,90 strains(64.29％) were isolated from the respiratory tract,30 strains (21.43％) were isolated from the urine samples.There was no resistant to ampicillin/sulbactam,piperacillin/tazobactam,amikacin and levofloxacin.The resistance rates to ampicillin,aztreonam,ceftriaxone,cefotetan and cefazolin were up to 96％;the resistance rate to ceftazidime,cefepime and imipenem were 20.36％,8.93％,2.14％,respectively.Conclusion Acinetobacter baumannii infection mainly cause infections in respiratory tract and urinary system,the resistance rates of Acinetobacter baumannii to common antibiotics in our hospital seem to be lower than those as literature reported.Penicillin and inhibitors of penicillinase may be used as the first choice for Acinetobacter baumannii infections.