摘要
目的了解住院患者分离出鲍曼不动杆菌的临床分布及耐药性变迁,指导临床合理应用抗生素。方法 2008年1月-2012年12月对住院患者的各种送检标本采用法国生物梅里埃公司的Vitek-2 compact全自动微生物鉴定仪进行细菌鉴定,药物敏感性试验采用K-B纸片扩散法,结果判定按照美国临床实验室标准化协会标准,数据分析使用Excel和SAS软件。结果 5年间共分离出鲍曼不动杆菌3 139株,来自2 013例患者;分离数量前3位的科室为灼伤科、重症监护病房以及胸外科病区;标本来源主要为痰液标本,占48.4%。鲍曼不动杆菌对多数抗菌药物耐药率为55%以上;β-内酰胺类/β-内酰胺酶抑制剂复合制剂的抗菌作用优于其单药成分;β-内酰胺类/β-内酰胺酶抑制剂复合制剂及碳青霉烯类抗生素的敏感率相对较高。结论鲍曼不动杆菌耐药现象严重,其耐药性存在医院差异,在临床治疗中应及时进行细菌耐药性的监测,根据药物敏感性试验结果选择合适的抗菌药物。
Objective To study the clinical distribution and the change of drug resistance of Acinetobacter baumannii from different inpatient specimens sources during 2008 to 2012, and to provide guidance for rational use of antibiotics. Methods The identification ofAcinetobacter baumannii was conducted by VITEK-2 based on clinical and laboratory standards institute （CLSI） guideline between January 2008 and December 2012. The susceptibility of antibiotics was determined by K-B test, and data analysis was conducted by Excel and SAS. Results A total of 3 139 stains of Acinetobacter baumannii were isolated from 2 013 patients during this period. The Acinetobacter baumannii was mainly obtained from the Bum ward, Intensive Care Unit ward and Thoracic ward. Sputum was the most specimens of Acinetobacter baumannii, accounting for 48.4%. The drug resistance rates ofAcinetobacter baumannii to most of the antimicrobial agents were more than 55%. Compound antibacterial is more effective than the single drug ingredient. Compared with other antimicrobial agents, β-lactams/β-lactamase inhibitor compound and carbapenems antimicrobial agents were more sensitive. Conclusions The drug resistance ofAcinetobacter baumannii is serious and has differences among hospitals. Clinicians should monitor the drug resistance ofAcinetobacter baumannii timely and choose proper antibiotics according to the results of drug sensitivity.
出处
《华西医学》
CAS
2014年第3期413-416,共4页
West China Medical Journal
基金
卫生部卫生公益性行业科研专项(201002021)~~
关键词
鲍曼不动杆菌
临床分布
耐药性
抗菌药物
Acinetobacter baumannii
Clinical distribution
Drug resistance
Antimicrobial agents
