摘要
目的：探讨本院患者下呼吸道分离鲍曼不动杆菌的耐药状况,为临床合理用药提供依据.方法： 收集我院2006年1月-2009年12月住院患者下呼吸道分离的非重复的342株鲍曼不动杆菌,采用Kirby-Bauer法进行药敏实验,数据用WHONET5.4软件及SPSS13.0软件进行分析.结果： 鲍曼不动杆菌感染以下呼吸道感染为主,临床分离率逐年升高.不同科室分离株的耐药率不同,其中ICU分离株耐药率最高,多重耐药菌株占33.0%,泛耐药菌株占13.7%.药敏结果显示,头孢哌酮-舒巴坦和亚胺培南对鲍曼不动杆菌保持较强的抗菌活性,其敏感率分别为80.1%和75.0%,其次为美罗培南57.2%.结论： 鲍曼不动杆菌多重耐药严重,集中分布于ICU,且临床分离株细菌耐药性仍呈增长趋势.碳青霉烯类药物和头孢哌酮-舒巴坦对鲍曼不动杆菌的体外抗菌活性最强,其它抗菌药物耐药率较高,应根据药敏试验结果合理选用抗生素进行治疗.
Objective To investigate the prevalence and antibiotic resistance of A. baumannii in lower respiratory infections for the rational use of antimicrobial agents. Methods A total of 342 nonduplicate strains of A. baomannii in lower respiratory infections were collected from January 2006 to December 2009. The antimicrobial susceptibility was analyzed by Kirby--Bauer disk diffusion method. The antimicrobial susceptibility data was analyzed by WHONET5.4 software and SPSS13.0 software. Results A. baumannii were mainly from lower respiratory tract. The prevalence of A. baumannii appeared to increase year by year. The resistance of A. baumannii varied from one department to another. The highest was in ICU. The antimicrobial susceptibility data demonstrated that the prevalence of multidrug-resistant A. baumannii（MDR--ABA） was up to 33.0%. The antimierobial susceptibility testing showed that Cefoperazone-sulbactam （80. 1% susceptible） and imipenem （75.0% susceptible） were the most active agents against A. baumannii, followed by meropenem（57.2 % susceptible）. Conclusions A. baumannii strains are highly resistant to multiple antibiotics. These strains are mainly isolated from ICU. Cefoperazone-sulbactam and Carbapenems are still the most effective antimicrobial agents in vitro against A. baumannii. A. baumannii is highly resistant to other antimicrobial agents. Therapy should be decided according to the results of the antimicrobial susceptibility testing.
关键词
鲍曼不动杆菌
下呼吸道感染
耐药性监测
Acinetobaeter baumannii
lower respiratory infection
resistance surveillance
carbapenem
