2008-2013年浙江萧山医院鲍曼不动杆菌临床分布及耐药性变迁[J]. 疾病监测, 2015, 30(1): 63-66. DOI: 10.3784/j.issn.1003-9961.2015.01.016
引用本文: 2008-2013年浙江萧山医院鲍曼不动杆菌临床分布及耐药性变迁[J]. 疾病监测, 2015, 30(1): 63-66. DOI: 10.3784/j.issn.1003-9961.2015.01.016
Clinical distribution and drug resistance evolution of Acinetobacter baumannii in Zhejiang Xiaoshan Hospital, 2008-2013[J]. Disease Surveillance, 2015, 30(1): 63-66. DOI: 10.3784/j.issn.1003-9961.2015.01.016
Citation: Clinical distribution and drug resistance evolution of Acinetobacter baumannii in Zhejiang Xiaoshan Hospital, 2008-2013[J]. Disease Surveillance, 2015, 30(1): 63-66. DOI: 10.3784/j.issn.1003-9961.2015.01.016

2008-2013年浙江萧山医院鲍曼不动杆菌临床分布及耐药性变迁

Clinical distribution and drug resistance evolution of Acinetobacter baumannii in Zhejiang Xiaoshan Hospital, 2008-2013

  • 摘要: 目的 调查鲍曼不动杆菌的临床分布特征和耐药状况,为医院各科室预防院内感染和治疗提供依据. 方法 K-B法检测药敏,VITEK-2 COMPACT全自动微生物分析系统鉴定细菌,利用WHONET 5.6对2008年1月至2013年12月浙江萧山医院住院和门诊患者送检标本中分离的鲍曼不动杆菌的分布及药敏结果进行回顾性分析,并对重症监护病房(ICU)和非ICU来源菌株耐药率进行比较. 结果 共分离鲍曼不动杆菌776株,以痰/呼吸道为主655株,占84.4%; 科室分布以ICU分离最多,219株占28.2%.2008年与2013年相比,头孢他啶、亚胺培南、庆大霉素等多种药物耐药率下降,但氨苄西林、头孢呋辛、氨曲南和头孢西丁耐药率始终保持较高(89.4%),头孢哌酮/舒巴坦耐药率较低(16.1%),亚胺培南和美罗培南耐药率分别为24.8%和27.7%;ICU病房与其他来源菌株在多种药物间耐药率差异有统计学意义 (P0.05). 结论 鲍曼不动杆菌广泛分布于临床科室各类标本中,是引起医院感染的重要非发酵菌,临床各科室尤其ICU应引起高度重视.头孢哌酮/舒巴坦可作为临床经验治疗的首选用药,严格规范医院感染和管理抗菌治疗,减少耐药菌株播散和防止耐药率的上升.

     

    Abstract: Objective To understand the clinical distribution and drug resistance of Acinetobacter baumannii in hospitals and provide references for the clinical diagnosis and treatment/prevention of nosocomial infection. Methods Retrospective statistical analysis was performed on the clinical distribution and drug resistance results of A. baumannii isolated from patient samples in our hospital from January 2008 to December 2013 by using WHONET 5.6. K-B methods was used to detect drug susceptibility, VITEK-2 COMPACT automated microbial analysis system was used for bacteria identification of bacteria and drug, resistant rates between ICU strains and non-ICU strains were compared. Results A total of 776 A. baumannii strains were isolated in our hospital, in which 655 were from respiratory tract samples (84.4%), and 219 strains were from ICU (28.2%). Compared with 2008, the resistant rates to ceftazidime, imipenem, gentamicin decreased in 2013, but the resistant rates to ampicillin, cefuroxime, aztreonam and cefoxitin remained high (89.4%), the resistant rates to cefoperazone/sulbactam was low (16.1%). The resistant rates to imipenem and meropenem were 24.8% and 27.7%; The resistant rates had significant difference between ICU strains and non ICU strains (P0.05). Conclusion A. baumannii, which is widely distributed in different clinical samples in hospitals, is an important non-fermentative bacteria causing nosocomial infection. It is necessary to pay more attention to A. baumannii infection in clinical departments especially in ICU. Cefoperazone/sulbactam can be used as the first choice for the treatment of A. baumannii infection. Strict management of nosocomial infection and standard antibiotic therapy can reduce the spread of resistant strains and prevent the development of drug resistance.

     

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