检验医学 ›› 2014, Vol. 29 ›› Issue (3): 245-248.DOI: 10.3969/j.issn.1673-8640.2014.03.010

• 临床应用研究·论著 • 上一篇    下一篇

2008至2012年鲍曼不动杆菌临床感染分布及耐药特征分析

徐一鸣,王蓓,蒋晓飞   

  1. 复旦大学附属华山医院检验科,上海 200040
  • 收稿日期:2013-05-04 出版日期:2014-03-30 发布日期:2014-04-19
  • 通讯作者: 蒋晓飞,联系电话:021-52889999。
  • 作者简介:徐一鸣,男,1983年生,学士,技师,主要从事细菌耐药机制研究。

Analysis on clinical distribution and resistance characteristic of Acinetobacter baumannii isolated clinically from 2008-2012

XU Yiming,WANG Bei,JIANG Xiaofei.   

  1. Department of Clinical Laboratory,Huashan Hospital,Shanghai Fudan University,Shanghai 200040,China
  • Received:2013-05-04 Online:2014-03-30 Published:2014-04-19

摘要:

目的 了解华山医院2008年1月至2012年9月临床分离鲍曼不动杆菌的临床分布特征及对抗菌药物的耐药性变迁,为临床合理使用抗菌药物提供依据。方法 采用纸片琼脂扩散法药物敏感性试验分析鲍曼不动杆菌对临床常用抗菌药物的耐药性及其耐药性变迁。结果 近5年,临床分离鲍曼不动杆菌以痰标本检出率最高,科室分布主要为神经外科和重症监护病房,其中神经外科该菌的分离率呈现明显上升趋势,从2008年的19.6%上升到2012年的35.3%。临床分离鲍曼不动杆菌耐药严重,其中对碳青霉烯类抗菌药物的耐药率上升最为明显,对亚胺培南的耐药率从2008年的57.5%上升至2012年的71.2%;对美罗培南的耐药率从2008年的56.8%上升至2012年的71.7%。对其他内酰胺类、头孢菌素类、氨基糖苷类、喹诺酮类等抗菌药物的耐药率总体维持在70.0%~80.0%之间。结论 鲍曼不动杆菌感染在神经外科和重症监护病房最为严重,且对常用药物普遍耐药,对碳青霉烯类抗菌药物的耐药率呈明显上升趋势,应加强鲍曼不动杆菌耐药监测,防止耐药菌的播散流行。

关键词: 鲍曼不动杆菌, 抗菌药物, 耐药率

Abstract:

Objective To investigate the clinical distribution and resistance characteristic trend of Acinetobacter baumannii in Huashan Hospital isolated clinically from January 2008 to September 2012,and to provide the reference for clinical rational using of antimicrobial agents. Methods The drug-resistance of Acinetobacter baumannii and resistance characteristic trend to common antimicrobial agents were analyzed by disk agar diffusion method. Results In the past 5 years,the detection rate of clinical isolated Acinetobacter baumannii from sputum specimens was highest,and mainly distributed in neurosurgery department and intensive care unit. The isolation rate in neurosurgery department presented obvious increasing trend from 19.6% in 2008 to 35.3% in 2012. The resistance of clinical isolated Acinetobacter baumannii was serious,and carbapenem antimicrobial agents had the obvious increasing trend. The resistance rate of imipenem rase from 57.5% in 2008 to 71.2% in 2012,the resistance rate of meropenem rase from 56.8% in 2008 to 71.7% in 2012,and the resistance rates of other lactams,cephalosporins,aminoglycosides and fluoroquinolones were 70.0%-80.0%. Conclusions The infection of Acinetobacter baumannii is serious in mainly neurosurgery department and intensive care unit. The clinical isolates are commonly resistant to all kinds of antimicrobial agents,and carbapenem antimicrobial agents present a obvious increasing trend. Monitoring the resistance of Acinetobacter baumannii should be strengthened for preventing resistant bacteria from spreading.

Key words: Acinetobacter baumannii, Antimicrobial agent, Resistance rate

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