【摘要】 目的了解鲍曼不动杆菌的感染分布特征及耐药性,为临床抗感染治疗提供有效的实验室依据。方法回顾性分析2010~2013年临床分离的鲍曼不动杆菌的分布和耐药情况,采用Whonet 5.6软件进行数据分析。结果共检出1 038株鲍曼不动杆菌,痰液标本占81.5%;主要分布在重症加强护理病房(ICU);该菌对多粘菌素B的耐药率最低,为0.6%,对头孢哌酮/舒巴坦、亚胺培南和美洛培南的耐药率分别为26.4%、35.5%和35.9%。对亚胺培南敏感的菌株对多粘菌素B、美洛培南、头孢哌酮/舒巴坦和氨苄西林/舒巴坦耐药率分别为0.5%、2.1%、3.2%和9.9%,对头孢曲松和头孢噻肟的敏感度低于30%,对其他药物的敏感度大于70%。对亚胺培南耐药的菌株,对多粘菌素B和头孢哌酮/舒巴坦耐药率分别为0.8%和65.5%,对其他药物的耐药率均在86%以上;耐药株主要分布于ICU和神经外科。结论碳青霉烯类和头孢哌酮/舒巴坦是治疗鲍曼不动杆菌的首选药物,对碳青霉烯类耐药鲍曼不动杆菌的治疗应联合用药,加强ICU和神经外科的消毒隔离措施和耐药性监测。更多还原

【Abstract】 Objective To explore the distribution characteristic and antibiotic resistance of Acinetobacter baumannii(A.baumannii)from 2010 to 2013.Methods The drug resistance and distribution were analyzed retrospectively by Whonet 5.6software from 2010 to 2013.Results There were 1 038 strains of A.baumannii detected out,primarily isolated from sputamentum samples,making up 81.5%,and most strains were from intensive-care unit(ICU).The resistance rate to polymyxin was the lowest as0.6%.The resistance rates to cefoperazone-sulbactam,imipenem and meropenem were 26.4%,35.5% and 35.9% respectively.Imipenem-susceptible strains showed lower resistance rate to polymyxin B(0.5%),followed by meropenem(2.1%),cefoperazonesulbactam(3.2%)and ampicillin-sulbactam(9.9%),the sensitive rate to cefotaxime and ceftriaxone were less than 30%,the resistance to other antimicrobial agents were greater than 70%.Imipenem-resistance strains showed lower resistance to polymyxin B(0.8%)and cefoperazone-sulbactam(65.5%),the resistance to other antimicrobial agents were greater than 86%,mainly distributed in ICU and neurosurgery.Conclusion Carbapenems and cefoperazone-sulbactam were the preferred drug to A.baumannii.The strains that resistance to carbapenem antibiotics should take combination treatment.It needs to enhance precautionary measures and monitor drug resistance.更多还原