乙酸钙鲍曼不动杆菌临床分离与耐药性的x年监测.doc

乙酸钙-鲍曼不动杆菌临床分离与耐药性的7年监测 吕火祥 魏琴 胡庆丰 杨广宇 沈蓓琼 钟华平 刘建栋 [ 摘要] 目的 了解从1998年到2004年乙酸钙-鲍曼不动杆菌在临床标本中的分离情况及其耐药趋势，为临床感染的预防和治疗提供参考资料。方法 回顾分析1998-2004年间所有标本中乙酸钙-鲍曼不动杆菌的分离率，菌株在标本和病区的分布情况以及对14种抗菌药物的耐药率。结果 乙酸钙-鲍曼不动杆菌的分离率有逐年升高的趋势，从1998年的0.18%增至2004年的1.48%;其在呼吸道标本（痰液+咽拭子）的分离率最高（70.58%），其次是尿液（9.42%），血液（4.63%）；病区分布以重症监护室最高（47.28%），其次是慢性病科（13.88%），再次为普外科（10.58%）；乙酸钙-鲍曼不动杆菌 对14种抗菌药的耐药率，1998年仅有氨曲南大于50%，而到2004年仅头孢哌酮/舒巴坦的耐药率小于50%，其他13种均大于50%。在检测的14种抗菌药物中其耐药率均呈递增的趋势，耐药性增幅列前三位分别为：头孢他啶11.1%-88.9%，亚胺培南0.0%-64.8%，复方新诺明0.0%-64.0%。结论 乙酸钙-鲍曼不动杆菌的临床分离率在增加，其对多数抗菌药物有较高的耐药性，且耐药率呈逐年上上升增高趋势，尤其是对亚胺培南耐药率的快速增长，应引起临床抗感染治疗的高度重视。 [关键词] 乙酸钙-鲍曼复合不动杆菌 ,分离率，耐药率 A 7-YEARS SURVEILLANCE STUDY ON ISOLATION AND RESISTANCE OF Acinetobacter baumannii IN HOSPTIAL (Lü Huo-xiang,WEI-Qin,,HU Qing-feng,Yang-Guangyu, ZHONG Hua-ping ,LIU Jiang-dong) Clinical Laboratory Medicine Centre of ZhejiangProvincial Hospital 310014 Abstract Objective To study the isolation and resistance tendency of Acinetobacter baumannii to antimicrobial agents from 1998 to 2004 to provide valuable data for infection prevention and therapy . Methods We reviewed the isolation rates ,distribution in clinical specimens and wards, and the resistance rates of Acinetobacter baumannii to 14 kinds of antimicrobial agents from 1998 to 2004. Results There was an increasing tendency of isolation rates of Acinetobacter baumannii every year, which was 0.18% in 1998 but 1.48% in 2004. In the seven years, there was a highest isolation rate of 70.58% in specimens from respiratory tract, the next was the urine (9.42%), the third was blood (4.63%). Concerning the wards distribution, ICU had a highest rate of 47.28% , the next was chronic disease department(13.88%) ,the general surgery department(10.58%) was third one. In 1998, Acinetobacter baumannii had resistance rates more than 50% only one kinds of antimicrobial agents(aztreonam), but in 2004,it had increased to thirteen kinds(except cefoperazone/sulbactam). About the fourteen kinds of antimicrobial