临床分离鲍曼不动杆菌的耐药特点与治疗策略

发布时间：2018-09-12 08:14

【摘要】：目的了解天津市红桥医院临床分离鲍曼不动杆菌的分布特征与耐药性,为合理使用抗菌药物提供依据。方法回顾性分析2010年1月-2015年12月临床分离鲍曼不动杆菌的标本分布与药敏试验结果。结果共收集鲍曼不动杆菌783株,主要来自痰标本,占81.0%,其次是咽拭子,占10.2%;科室分布以呼吸内科和重症监护病房为主,分别占41.6%、23.4%。该菌对头孢哌酮/舒巴坦和米诺环素的耐药率最低,分别为2.55%、4.34%;耐药率最高的抗菌药物为氨曲南和甲氧苄啶/磺胺甲VA唑,分别为62.71%、35.89%;对其他β-内酰胺类、头孢菌素类、氨基糖苷类、喹诺酮类等抗菌药物的耐药率保持在20.0%~35.0%之间;除对头孢哌酮/舒巴坦、米诺环素、美罗培南连续6年间耐药率变化无明显差异(P0.05),其他15种抗生素6年间的耐药率变化均差异明显(P0.05)。临床分离鲍曼不动杆菌对美罗培南和亚胺培南耐药率分别由2010年的5.58%和5.58%上升到2015年的10.42%和14.58%。连续6年多重耐药鲍曼不动杆菌总检出率为15.5%,各年度间检出率差异无统计学意义(P0.05)。结论该院临床治疗鲍曼不动杆菌引起感染的经验性用药,可选择氨基糖苷类、喹诺酮类、头孢菌素类等药物,尽量在药敏试验结果指导下合理选用抗菌药物。
[Abstract]:Objective to investigate the distribution and drug resistance of Acinetobacter baumannii isolated in Hongqiao Hospital of Tianjin. Methods the distribution and drug sensitivity of Acinetobacter baumannii isolated from January 2010 to December 2015 were analyzed retrospectively. Results A total of 783 strains of Acinetobacter baumannii were collected, mainly from sputum, accounting for 81.0, followed by swabs of pharynx, accounting for 10.2. The resistance rates of cefoperazone / sulbactam and minocycline were the lowest, 2.55 and 4.34, respectively. The highest resistance rates were amtreonam and trimethoprim / sulfamethoxazole (62.71and 35.89cm, respectively; for other 尾 -lactams, cephalosporins, cephalosporins). The resistance rate of aminoglycosides, quinolones and other antimicrobial agents remained between 20.0% and 35.0%, except for cefoperazone / sulbactam, minocycline, minocycline, There was no significant difference in drug resistance rate of meropenem for 6 consecutive years (P0.05), but there was significant difference in resistance rate of other 15 antibiotics in 6 years (P0.05). The resistance rates of Acinetobacter baumannii to meropenem and imipenem increased from 5.58% and 5.58% in 2010 to 10.42% and 14.58% in 2015, respectively. The total detection rate of Acinetobacter baumannii for 6 consecutive years was 15.5. there was no significant difference in detection rate between different years (P0.05). Conclusion in clinical treatment of Acinetobacter baumannii infection, aminoglycosides, quinolones, cephalosporins and other drugs can be selected.
【作者单位】：天津医科大学研究生院;天津市红桥医院;天津医科大学总医院;
【分类号】：R446.5

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