摘要
目的分析鲍氏不动杆菌的临床分布特征及对抗菌药物的耐药性变迁,为鲍氏不动杆菌感染的控制及治疗提供合理依据。方法收集遵义医学院附属医院2014年1月-2016年9月从各种送检的标本中分离的感染菌株,对分离的感染菌进行快速细菌鉴定,并利用全自动微生物鉴定及药敏分析仪进行药敏试验。结果近3年总共分离鲍氏不动杆菌1 010株,主要来源于痰标本,所占比例均>55.0%,其次来源于分泌物及血液标本;临床分离的鲍氏不动杆菌中ICU检出率最高,且对17种临床常用抗菌药物的耐药性均较高,有逐年上升的趋势,其中对氨曲南、呋喃妥因、头孢替坦几乎100.0%耐药,头孢哌酮/舒巴坦由22.9%升至62.7%,亚胺培南由52.4%升至72.7%;而对多黏菌素B较敏感,但耐药率仍然不断增高,依次为0.9%、1.3%、5.9%;多药耐药(MDR)鲍氏不动杆菌检出率逐年上升,且各年检出率均>60.0%;泛耐药(XDR)鲍氏不动杆菌检出率上升更为明显,从20.0%左右升至55.0%。结论遵义医学院附属医院鲍氏不动杆菌临床检出率及耐药率不断增高,MDR及XDR现象越来越明显,多黏菌素B可作为鲍氏不动杆菌感染的首选药物;加强动态监测,以降低医院鲍氏不动杆菌耐药率。
OBJECTIVE To investigate the clinical characteristics of distribution of Acinetobacter baumannii strains and analyze the change of drug resistance so as to provide theoretical basis for control and treatment of A.baumannii infection.METHODS The pathogens were isolated from various submitted specimens that were obtained from Affiliated Hospital of Zunyi Medical College from Jan 2014 to Sep 2016,the rapid bacterial identification was carried out for the isolated pathogens,and drug susceptibility testing were performed.RESULTS A total of 1 010 strains of A.baumannii were isolated in the recent 3years,of which more than 55.0% were isolated from sputum specimens,followed by secretions and blood specimens.The isolation rate of the clinical A.baumannii isolates was the highest in ICU,the drug resistance rate of the strains to 17 kinds of commonly used antibiotics was high and showed an upward trend;the drug resistance rate to aztreonam,nitrofurantoin,and cefotetan was nearly100.0%,the drug resistance rate to cefoperazone-sulbactam was increased from 22.9% to 62.7%,and the drug resistance rate to imipenem was increased from 52.4%to 72.7%.The strains were highly susceptible to polymyxin B,and the drug resistance rate was 0.9%in 2014,1.3%in 2015,5.9%in 2016,showing an increasing trend.The isolation rate of multidrug-resistant（MDR）A.baumannii strains was increased year by year,which was more than 60.0%in each of the three years;the isolation rate of pandrug-resistant（PDR）A.baumannii strains was increased more significantly,which was increased from 20.0% to 55.0%.CONCLUSIONBoth the clinical isolation rate and drug resistance rate of the A.baumannii strains isolated from Affiliated Hospital of Zunyi Medical College are increasing,and the MDR A.baumannii and PDR A.baumannii strains become more and more prevalent.Polymyxin B should be used as the preferred antibiotic for treatment of A.baumannii infection.It is necessary to strengthen dynamic monitoring so as to reduce the drug resistance rate of the A.baumannii strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第9期1936-1939,共4页
Chinese Journal of Nosocomiology
基金
贵州省科技厅资助项目(黔科合LH[2015]7480)
遵义医学院基金资助项目(院字[2009]22号)
贵州省教育厅资助项目(SJJG2016-05-99)
关键词
鲍氏不动杆菌
抗菌药物
临床特征
耐药性
Acinetobacter baumannii
Antibiotic
Clinical characteristic
Drug resistance
