2005—2014年CHINET不动杆菌属细菌耐药性监测

发布时间：2018-05-17 01:21

本文选题：鲍曼不动杆菌 + 多重耐药　；参考：《中国感染与化疗杂志》2016年04期

【摘要】：目的了解2005-2014年中国主要地区19所医院临床分离的不动杆菌属细菌分布及其耐药性变化趋势。方法共收集19所教学医院临床分离的55 154株不动杆菌属细菌,其中鲍曼不动杆菌49 153株。按照统一方案,采用纸片扩散法或自动化仪器法进行药敏试验,按CLSI 2014年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析。结果10年间,不动杆菌属细菌的检出率呈上升趋势:2005年为10.0%,2014年为11.1%。55 154株不动杆菌属主要分离自住院患者占92.0%,门急诊8.0%。28.5%不动杆菌属分离自ICU,其次为内科病房28.1%。从2005年开始,鲍曼不动杆菌对头孢菌素类、喹诺酮类、氨基糖苷类药物的耐药率均在60%以上,对头孢哌酮-舒巴坦和亚胺培南的耐药率较低,分别为28.8%和32.9%。特别从2008年开始,多所医院耐药率明显增加,多重耐药菌和广泛耐药菌比率也明显增加。不同医院的菌株对抗菌药物的耐药率不同,不同科室分离株的耐药率亦不同,其中以ICU分离株对受试抗菌药物的耐药率最高,除头孢哌酮-舒巴坦和米诺环素外,对其余受试抗菌药物的耐药率在60%以上。结论从2008以后,鲍曼不动杆菌对氨苄西林-舒巴坦、头孢哌酮-舒巴坦和米诺环素的耐药率逐年增高,特别是对碳青霉烯类药物耐药率明显升高。不同地区医院鲍曼不动杆菌的耐药率相差较大,不同科室的耐药率也有很大差异。
[Abstract]:Objective to investigate the distribution and drug resistance of Acinetobacter isolated from 19 hospitals in China from 2005 to 2014. Methods A total of 55,154 strains of Acinetobacter were collected from 19 teaching hospitals, 49,153 of which were Acinetobacter baumannii. According to the unified scheme, the drug sensitivity test was carried out by using disk diffusion method or automatic instrument method. The drug sensitivity results were interpreted according to CLSI 2014 standard, and the data were analyzed by WHONET 5.6 software. Results the positive rate of Acinetobacter bacteria showed an upward trend in ten years: 10.0 in 2005, 11.1 in 2014, 11.1 in 2014, 92.0% in hospitalized patients, 8.0.28.5% in outpatient and emergency department, followed by 28.1in medical ward. Since 2005, the resistance rates of Acinetobacter baumannii to cephalosporins, quinolones and aminoglycosides were all above 60%, and the resistance rates to cefoperazone-sulbactam and imipenem were 28.8% and 32.9%, respectively. Especially since 2008, the rate of drug resistance in many hospitals has increased significantly, and the ratio of multidrug resistant bacteria and widespread drug resistant bacteria has also increased significantly. The antibiotic resistance rates of strains in different hospitals were different, and the drug resistance rates of strains in different departments were also different. The resistance rate of ICU isolates to tested antibiotics was the highest, except for cefoperazone-sulbactam and minocycline. The rate of resistance to other antimicrobial agents was more than 60%. Conclusion after 2008, the resistance rates of Acinetobacter baumannii to ampicillin-sulbactam, cefoperazone-sulbactam and minocycline increased year by year, especially to carbapenems. The drug resistance rate of Acinetobacter baumannii in different hospitals varied greatly, and the resistance rate of Acinetobacter baumannii in different departments was also very different.
【作者单位】：中国医学科学院北京协和医学院北京协和医院检验科;天津医科大学总医院;华中科技大学同济医学院附属同济医院;复旦大学附属华山医院;广州医科大学附属第一医院;中国医科大学附属第一医院;浙江大学医学院附属邵逸夫医院;安徽医科大学第一附属医院;上海交通大学医学院附属瑞金医院;新疆医科大学第一附属医院;甘肃省人民医院;复旦大学附属儿科医院;上海交通大学附属儿童医院;北京医院;昆明医科大学第一附属医院;浙江大学附属第一医院;四川大学华西医院;内蒙古医科大学附属医院;重庆医科大学附属第一医院;
【分类号】：R446.5

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