上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (1): 46-.doi: 10.3969/j.issn.1674-8115.2013.01.009

• 论著（临床研究） • 上一篇    下一篇

连续6年间鲍曼不动杆菌药物敏感率变迁及对策分析

肖淑珍1, 糜琛蓉2, 韩立中1, 陈 旭1, 倪语星1   

  1. 上海交通大学 医学院附属瑞金医院 1.临床微生物科, 2.感染管理科, 上海 200025
  • 出版日期:2013-01-28 发布日期:2013-02-06
  • 作者简介:肖淑珍（1988—）, 女, 硕士生；电子信箱: zndxxsz@163.com。
  • 基金资助:

    卫生公益性行业科研专项基金（201002021）

Variation of drug susceptibility of Acinetobacter baumannii within 6 years and countermeasure analysis

XIAO Shu-zhen1, MI Chen-rong2, HAN Li-zhong1, CHEN Xu1, NI Yu-xing1   

  1. 1.Department of Clinical Microbiology, 2.Infection Control Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2013-01-28 Published:2013-02-06
  • Supported by:

    Special Fund for Health-scientific Research in the Public Interest, 201002021

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摘要：

目的 了解鲍曼不动杆菌的临床分布及药物敏感率变迁，分析其耐药性发展趋势，为临床用药和感染控制提供依据并提出相应对策。方法 收集2006年1月—2011年12月在该院临床微生物科分离得到并有药敏结果的鲍曼不动杆菌共2 397株，分析鲍曼不动杆菌在各科室的分布情况。K-B法检测鲍曼不动杆菌对13种临床常用抗菌药物的敏感率。结果 连续6年间临床分离的鲍曼不动杆菌分布无明显变化，主要分布于烧伤科、心胸外科、普外科、呼吸科、血液科和老年科等科室；对常用抗菌药物的敏感率呈整体下降趋势。门诊及内科分离的菌株对三代头孢、喹诺酮类和氨基糖苷类的敏感率相对较高，而急诊、外科和重症监护病房（ICU）分离的菌株敏感率相对较低。结论 鲍曼不动杆菌对抗菌药物的敏感率逐年降低，需引起临床的高度重视。不同科室分离的细菌耐药谱不一致，临床医师需根据细菌的药物敏感性试验结果合理选用抗菌药物；同时还应加强医院感染监控，减少耐药菌的传播。

关键词: 鲍曼不动杆菌, 耐药, 感染, 抗菌药物

Abstract:

Objective To investigate the clinical distribution and variation of drug resistance of Acinetobacter baumannii, and provide reference for antibiotic drug usage and infection control. Methods A total of 2 397 clinical isolates of Acinetobacter baumannii with result of drug sensitivity test were collected from Department of Clinical Microbiology of the hospital, and the distribution of isolates of Acinetobacter baumannii in clinical departments was analyzed. The sensitivity of Acinetobacter baumannii to 13 commonly used antibiotic drugs was determined by K-B method. Results There was no significant change in the distribution of clinical isolates of Acinetobacter baumannii within 6 years. The most common locations of Acinetobacter baumannii were Department of Burn, Department of Cardiothoracic Surgery, Department of Surgery, Department of Respirology, Department of Hematology and Department of Geriatrics. The sensitivity of Acinetobacter baumannii to commonly used antibiotic drugs generally descended. Isolates from section for outpatients and internal medicine departments were more sensitive to third-generation cephalosporin, fluoroquinolone and aminoglycosides, while strains from emergency department, surgical departments and intensive care unit (ICU) had a higher rate of drug resistance. Conclusion The sensitivity of Acinetobacter baumannii to antibiotic drugs decreases year by year, which should be paid more attention. Doctors should choose proper antibiotic drugs for different departments based on antimicrobial susceptibility results. Infection monitoring should be enhanced in hospitals to reduce the spread of drug-resistant bacteria.

Key words: Acinetobacter baumannii, resistance, infection, antibiotic drugs