2014-2016年鲍氏不动杆菌临床分布特征及耐药性变迁

发布时间：2018-11-28 20:14

【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。
[Abstract]:Objective to analyze the clinical distribution and antimicrobial resistance of Acinetobacter baumannii and to provide reasonable basis for the control and treatment of Acinetobacter baumannii infection. Methods from January 2014 to September 2016, the infected strains isolated from various samples of Zunyi Medical College affiliated Hospital were collected and identified quickly. The drug sensitivity test was carried out by automatic microbial identification and drug sensitivity analyzer. Results A total of 1010 strains of Acinetobacter baumannii were isolated in the past three years, mainly from sputum samples, accounting for 55.0% of them, followed by secretions and blood samples. Among the strains of Acinetobacter baumannii, the detection rate of ICU was the highest, and the resistance to 17 kinds of commonly used antimicrobial agents was higher, and the resistance to aztreonam, furantoin and ceftitan was almost 100.0%. Cefoperazone / sulbactam increased from 22.9% to 62.7%, imipenem from 52.4% to 72.7%. But the rate of drug resistance to polymyxin B was still increasing, which was 0.90.3.The detection rate of Acinetobacter baumannii with multidrug resistance (MDR) increased year by year, and the detection rate of Acinetobacter baumannii was 60.0in each year. The detection rate of pan-resistant (XDR) Acinetobacter baumannii increased from 20.0% to 55.0%. Conclusion the clinical detection rate and drug resistance rate of Acinetobacter baumannii in affiliated Hospital of Zunyi Medical College are increasing. The phenomenon of MDR and XDR is becoming more and more obvious. Polymyxin B can be used as the first choice drug for Acinetobacter baumannii infection. Strengthen dynamic surveillance to reduce the drug resistance rate of Acinetobacter baumannii in hospital.
【作者单位】：遵义医学院附属医院检验科;遵义医学院检验系;
【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)
【分类号】：R446.5

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