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目的了解天津市红桥医院临床分离鲍曼不动杆菌的分布特征与耐药性,为合理使用抗菌药物提供依据。方法回顾性分析2010年1月-2015年12月临床分离鲍曼不动杆菌的标本分布与药敏试验结果。结果共收集鲍曼不动杆菌783株,主要来自痰标本,占81.0%,其次是咽拭子,占10.2%;科室分布以呼吸内科和重症监护病房为主,分别占41.6%、23.4%。该菌对头孢哌酮/舒巴坦和米诺环素的耐药率最低,分别为2.55%、4.34%;耐药率最高的抗菌药物为氨曲南和甲氧苄啶/磺胺甲噁唑,分别为62.71%、35.89%;对其他β-内酰胺类、头孢菌素类、氨基糖苷类、喹诺酮类等抗菌药物的耐药率保持在20.0%~35.0%之间;除对头孢哌酮/舒巴坦、米诺环素、美罗培南连续6年间耐药率变化无明显差异(P>0.05),其他15种抗生素6年间的耐药率变化均差异明显(P<0.05)。临床分离鲍曼不动杆菌对美罗培南和亚胺培南耐药率分别由2010年的5.58%和5.58%上升到2015年的10.42%和14.58%。连续6年多重耐药鲍曼不动杆菌总检出率为15.5%,各年度间检出率差异无统计学意义(P>0.05)。结论该院临床治疗鲍曼不动杆菌引起感染的经验性用药,可选择氨基糖苷类、喹诺酮类、头孢菌素类等药物,尽量在药敏试验结果指导下合理选用抗菌药物。
Objective To understand the distribution characteristics and drug resistance of Acinetobacter baumannii isolated from Hongqiao Hospital in Tianjin and provide evidence for rational use of antimicrobial agents. Methods The distribution of specimens and drug susceptibility test results of Acinetobacter baumannii isolated from January 2010 to December 2015 were retrospectively analyzed. Results A total of 783 Acinetobacter baumannii strains were collected, mainly from sputum samples, accounting for 81.0%, followed by throat swabs, accounting for 10.2%. The departments were mainly respiratory medicine and intensive care units, accounting for 41.6% and 23.4% respectively. The resistance rate to cefoperazone / sulbactam and minocycline in this strain was the lowest (2.55% and 4.34%, respectively). The most resistant antibiotics were aztreonam and trimethoprim / sulfamethoxazole , Respectively, 62.71%, 35.89%; to other β-lactams, cephalosporins, aminoglycosides, quinolones and other antimicrobial resistance rates remained between 20.0% ~ 35.0%; in addition to cefoperazone / Sulbactam, minocycline and meropenem for 6 consecutive years (P> 0.05). The resistance rates of other 15 antibiotics were significantly different in 6 years (P <0.05). The clinical isolates of Acinetobacter baumannii increased the rates of resistance to meropenem and imipenem from 5.58% and 5.58% in 2010 to 10.42% and 14.58% in 2015 respectively. The total detection rate of multidrug-resistant Acinetobacter baumannii was 15.5% for six consecutive years, with no significant difference between the years (P> 0.05). Conclusion The hospital clinical treatment of Acinetobacter baumannii infection caused by empirical medication, the choice of aminoglycosides, quinolones, cephalosporins and other drugs, as far as possible in the drug sensitivity test results under the guidance of rational use of antimicrobial agents.