2013～2015年我院鲍曼不动杆菌的临床分布及耐药性分析.docVIP

2013～2015年我院鲍曼不动杆菌的临床分布及耐药性分析 　　[摘要]目的 分析我院鲍曼不动杆菌的临床分布及耐药情况，为临床合理用药提供准确数据。方法 应用Siemens MicroScan WalkAway96 plus全自动细菌鉴定及药敏仪、WHONET5.6计算机统计软件对辽阳市中心医院2013年1月1日～2015年12月30日住院患者分离出的鲍曼不动杆菌564株进行分析。结果 鲍曼不动杆菌在痰、尿液、分泌物中检出率较高，分别为84.93%、5.32%和3.01%；分布的主要科室为ICU（47.87%）、神经外科（16.67%）、呼吸内科（7.62%）等。鲍曼不动杆菌对复方磺胺甲唑的耐药率最低（49.67%），其次是头孢哌酮/舒巴坦、亚胺培南、四环素、左氧氟沙星等，其他药物耐药率更高，氨苄西林和头孢唑林达到100.00%，98.82%耐药。结论 鲍曼不动杆菌在我院的检出率较高，耐药性强，给临床治疗带来较大的麻烦，极有可能造成扩散性的院内感染，应引起临床医生和感染科的高度重视，为本地基层医院的合理用药奠定一定的基础。 　　[关键词]鲍曼不动杆菌；合理用药；细菌耐药性；院内感染 　　[中图分类号] R378 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0149-03 　　[Abstract]Objective To analyze the clinical distribution and drug resistance of Acinetobacter baumannii in our hospital，and provide accurate data for clinical rational drug use.Methods 564 strains of Acinetobacter baumannii were isolated from the hospitalized patients during January 1st 2013 to December 30th 2015 with Siemens the MicroScan WalkAway96 plus，an automatic bacteria identification and drug susceptibility instrument，and the computer statistical software WHONET5.6.Results There were higher detection rate in sputum，urine and secretions，84.93%，5.32% and 3.01%，respectively.Mainly distributied in ICU（47.87%），neurosurgical unit （16.67%），respiratory medicine wards （7.62%），and so on.Acinetobacter baumannii had the lowest resistance to SMZ-TMP（49.67%）.Cefperazone-Sulbactam，imipenem，tetracycline，and levofloxacin came the next.Other medicine had higher drug resistance rate.In addition，Acinetobacter baumannii resistance to ampicillin and cefazolin was 100.00% and 98.82% respectively.Conclusion There is a great detection rate in our hospital of Acinetobacter baumannii with a strong drug resistance rate.It can bring a lot of trouble to clinical treatment and cause diffusible nosocomial infection most likely，which should be paid more attention for the clinicians and the infectious disease department. 　　[Key words]Acinetobacter baumannii；Rational drug use；Bacteria drug resistance；Nosocomial infection 　　鲍曼不动杆菌（A