摘要
目的了解医院感染鲍氏不动杆菌分布特点和变迁趋势,为临床合理使用抗菌药物,减少耐药性提供参考。方法对2005-2011年临床分离的鲍氏不动杆菌分布构成及耐药性进行统计分析。结果 7年检出鲍氏不动杆菌共1973株,来源标本为呼吸道、尿液、伤口分泌物、血液、引流液,分别占85.4%、3.7%、3.2%、2.1%、2.1%;分离自ICU占35.0%、非ICU占65.0%;鲍氏不动杆菌耐药率及多药耐药菌检出率逐年增加;ICU比非ICU科室的整体耐药水平偏高;鲍氏不动杆菌对头孢哌酮/舒巴坦、亚胺培南和美罗培南的平均耐药率分别为22.4%、28.7%和29.2%,仍是经验用药的首选;对头孢他啶、头孢曲松和头孢吡肟的平均耐药率分别为46.4%和44.5%;对替卡西林/克拉维酸、哌拉西林/他唑巴坦和磺胺甲噁唑/甲氧苄啶的平均耐药率分别为44.3%、37.1%和52.2%;对阿米卡星和左氧氟沙星的平均耐药率分别为28.1%和36.8%。结论 7年鲍氏不动杆菌的构成比及耐药率均呈上升趋势,加强医院感染病例的细菌学监测和动态分析,对制定有效的感染控制措施、杜绝感染暴发流行具有积极意义。
OBJECTIVE To investigate the distribution of Acinetobacter baumannii and the change in the drug resistance so as to guide the reasonable use of antibiotics and reduce the drug resistance.METHODS The distribution and drug resistance rates of the clinical isolates of Acinetobacter baumannii were statistically analyzed from 2005 to 2011.RESULTS A total of 1973 strains of A.baumannii were isolated during the past seven years,among which 85.4% were isolated from the respiratory tract,3.7% from urine,3.2% from secretions,2.1% from blood,and 2.1% from drainage fluid.35.0% of the strains were isolated from the ICUs and 65.0% were isolated from the non-ICU departments.The detection rates of both the A.baumannii and the MDA increased year by year.The overall drug resistance rate of the strains isolated from the ICU was higher than that of the strains isolated from the non-ICU departments;the average drug resistance rates of the A.baumannii to cefperazonesulbactam imipenem,and meropenem were 22.4%,28.7%,and 29.2%,respectively,which were the preferred choice for the empirical treatment;the average resistance rates to ceftazidime,ceftriaxone,and cefepime were 46.4% and 44.5%,respectively;the average resistance rates to ticarcillin-clavulanate,piperacillin-tazobactam,and trimethoprim-sulfamethoxazole were 44.3%,37.1%,and 52.2%,respectively;the average resistance rates to amikacin and levofloxacin were 28.1%and 36.8%,respectively.CONCLUSION The constituent ratios and the drug resistance rate of the A.baumannii strains show an upward trend during the seven years.It is of positive significance to formulate the effective infection control measures and prevent the outbreak and epidemic of infections by strengthening the bacteriological monitoring and dynamics of the cases with nosocomial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第14期3512-3514,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局面上基金(2011KY08)
关键词
鲍氏不动杆菌
耐药性
抗菌药物
Acinetobacter baumannii
Drug resistance
Antibiotic
