摘要
目的:分析沈阳军区总医院2005～2008年4个年度间鲍曼不动杆菌(Acinetobacter baumannii,Aba)检出率及耐药性变迁规律,主要药物用量与耐药率变化之间的关系,为有效控制Aba感染率及耐药性不断上升的研究提供流行病学资料,也为临床医生用药提供指导。方法:统计本院2005年1月～2008年12月临床送检标本中Aba检出率、耐药率、抗生素用量并分析三者间相互关系。结果:Aba菌株检出率2005、2006年度<3%,接下来的2个年度迅速上升到8.6%和15.7%;期间Aba对常用药物的耐药率逐年上升,2008年的敏感率已下降到30%以下;碳青霉烯类药物在2005、2006年度保持95%以上的敏感率,2007年开始,其敏感性急剧下降,2008年敏感率只有30%;对Aba最有效的药物为头孢哌酮/舒巴坦,其敏感性也从2006年度的91.4%下降到了2008年度的47.2%。随碳青霉烯类药物用药频度的增加,Aba对该类药物的耐药率在2年中无明显变化,累积2年后Aba对其耐药率急剧升高。4年中,左氧氟沙星、头孢吡肟用药频度与耐药率有相同的变化趋势;头孢他啶、阿米卡星用药频度下降,但耐药率依然呈上升趋势。结论:Aba的临床检出率和耐药率上升呈一致性趋势;不同药物之间相互诱导耐药的机制在临床实践中应予足够的重视,制定临床抗生素用药策略如抗生素交替使用以达到降低细菌耐药目的情况下,应充分考虑到不同类型药物之间的诱导耐药现象。
Objective：To analyze the vicissitade of drag-resistance and the detection rate ofAcinetobacter baumannii（Aba）and provide basis for selection of clinical drugs.Methods：The data concerning aba infection in our hospital during 2006-2008 were retrospectively and statistically analyzed.Resnlts：90% of Aba were, isolated from spotum specimens.＇rhe detection rate of Aba Strain in 2006 year was only 2.6%,over the next two years were 8,6% and 15,7%.During this period Aba resistant to commonly used drugs have also increased year by year, The most effective drug for Aba was eefoperazom/sulbaetam and its sensitivity to Aba fell from 91.4% in the 2006 year to 47,2% in the 2008 year.but other types of drugs.the scnsmvlty have decreased to 30%.With the Carbapenem DDDs increase.the drug-resistance rate of Aba has no significant change in two years.Aftet two years of cumulative Platlbrrnthe,the drug-resistant rate of Aba rapid increased.In 4 years, the DDDs of levofloxacin and eefepime have die same trend with the drug^reststance rates of aba：with the DDDs of ceftazidime and amikacin declined,the drug-resistance rates ＇s still on the rise.Conclusion：The change of Aba clinical detection rate was consistent trend with the increasing of the drug-resistance rate,To develop the elizaical strategy of antibiotic drags such as antibiotics used in rum to in order to achieve the purpose of reducing bacterial resistance to antibiotics,the phenomenon of indoeod resistance among the different types of drugs should be fully taken into account.
出处
《中国医药导刊》
2010年第3期469-471,共3页
Chinese Journal of Medicinal Guide
关键词
鲍曼不动杆菌
耐药率
用药频度
Acinetobacter baumannii
Consumption,Drug resistance
