摘要
目的了解复旦大学附属浦东医院鲍曼不动杆菌的临床分布特点及耐药性变迁趋势,为临床合理用药、控制感染提供指导。方法应用SPSS 19.0软件对该院2010年1月至2014年10月分离的1 678株鲍曼不动杆菌的标本来源、病区分布及耐药性变迁进行回顾性统计学分析。结果临床分离的鲍曼不动杆菌主要来源于呼吸道标本（79.1%）,病区分布主要为重症监护室（21.1%）、神经外科（17.7%）和心内科（17.6%）。鲍曼不动杆菌对一代头孢、二代头孢、头霉烯类、氨苄西林和呋喃妥因高度耐药,耐药率达90%以上;对碳青霉烯类抗菌药物、氨曲南及头孢哌酮/舒巴坦和氨苄西林/舒巴坦的耐药率呈明显升高趋势;对阿米卡星和复方磺胺甲噁唑的耐药率呈逐年下降趋势;对其他抗菌药物的耐药率多保持在30%~50%。5年间多重耐药菌株检出率稳定在35.0%左右,泛耐药菌株检出率呈逐年下降,但每年均有检出。结论该院鲍曼不动杆菌耐药情况严重,多重耐药及泛耐药现象持续存在,应加强耐药监测,合理规范用药,做好消毒隔离工作,防止耐药鲍曼不动杆菌在医院内的播散和流行。
Objective To investigate the clinical distribution characteristics and trend in antibacterial resistance of Acinetobacter baumannii in Pudong Hospital Affiliated to Fudan University,so as to provide the guidance for clinical rational use of antibacterial agents and infection control.Methods SPSS 1 9.0 statistical software was adopted to retrospectively analyze the specimen source, department distribution and antibacterial resistance change of the 1 678 strains of Acinetobacter baumannii in this hospital from Jan-uary 2010 to October 2014.Results Clinical isolates of Acinetobacter baumannii mainly came from respiratory tract specimens（ac-counted for 79.1%）.The intensive care unit（21.1%）,department of neurosurgery（1 7.7%）and department of cardiology（1 7.6%） were the top three departments from which the strains were isolated.The isolates of Acinetobacter baumannii were highly resistant to the first and second generation of cephalosporins,cephamycin,ampicillin and nitrofurantoin,and the resistance rates reached a-bove 90%.The resistance rates of these isolates against carbapenems,aztreonam,cefperazone-sulbactam and ampicillin-salbactam showed obviously uptrends,but the resistance rates of these isolates against amikacin and cotrimoxazole showed downtrends.And the resistance rates of these isolates against other antibacterial agents stayed between 30% and 50%.During the five years,the de-tection rates of multi-drug resistant strains steadied around 35.0%.Though the detection rates of pan-drug resistant strains de-clined year by year,the strains were isolated each year.Conclusion The antibacterial resistance of Acinetobacter baumannii is seri-ous in this hospital,with multi-drug and pan-drug resistance persisting.It is necessary to enhance monitoring antibacterial resist-ance,ensure rational use of antibacterial agents,and promote implementation of disinfection and isolation,so as to prevent the spread and popularity of Acinetobacter baumannii resistance in hospital.
出处
《国际检验医学杂志》
CAS
2015年第13期1899-1901,1904,共4页
International Journal of Laboratory Medicine
关键词
鲍曼不动杆菌
临床分布
耐药性
Acinetobacter baumannii
clinical distribution
antibacterial resistance
