耐碳青霉烯类鲍曼不动杆菌临床分布及耐药谱动态观察
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汪宏良

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R378

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Distribution characteristics and dynamic observation of antimicrobial resistant spectrum of carbapenemresistant Acinetobacter baumannii
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    摘要:

    目的探讨耐碳青霉烯类鲍曼不动杆菌(CRAB)临床分布特点与耐药情况,为临床合理使用抗菌药物、CRAB感染的治疗及其医院感染的防控提供参考依据。方法回顾性分析2009年1月—2013年12月临床标本分离的CRAB临床资料, 应用WHONET 5.5软件统计其标本分布和耐药情况。结果5年共分离鲍曼不动杆菌(AB)标本888株,检出CRAB 421株, 检出率为47.4%,其中2011、2012和2013年检出率均在50.0%左右;标本来源以痰为主,占73.4%;科室分布以重症监护室(ICU)为主,占61.3%, 其次是神经外科病房, 为12.4%。CRAB呈现高度耐药性,除头孢噻肟和头孢曲松外,CRAB对检测的其他抗菌药物(头孢他啶、头孢吡肟、头孢哌酮/舒巴坦、氨曲南、亚胺培南、阿米卡星、庆大霉素、米诺环素、氯霉素、左氧氟沙星、环丙沙星、复方磺胺甲口恶唑)耐药率均高于非CRAB,差异均有统计学意义( 均P≤0.01);5年来对头孢哌酮/舒巴坦耐药率最低(<15%), 其次是米诺环素,对其余抗菌药物耐药率多>80.0%。结论应继续加强CRAB监测, 重点关注ICU及呼吸系统医院感染的预防控制。

    Abstract:

    ObjectiveTo investigate the distribution characteristics and antimicrobial resistance of carbapenemresistant Acinetobacter baumannii  (CRAB), and to guide effective clinical prevention and rational antimicrobial  use.MethodsData about clinically isolated CRAB between January 2009 and December 2013 were analyzed retrospectively, distribution and antimicrobial resistance were analyzed by WHONET 5.5 software.ResultsA total of 888 Acinetobacter baumannii strains were isolated,421  of which were CRAB, the isolation rate was 47.4%, the isolation rates in 2011, 2012 and 2013 were all about 50.0%; CRAB strains were mainly isolated from sputum (73.4%) and mostly distributed in intensive care unit(ICU) (61.3%), followed by neurosurgery department(12.4%). CRAB presented highly antimicrobial resistance. Except cefotaxime and cefatriaxone, resistant rates of CRAB to the other detected antimicrobial agents(ceftazidime, cefepime, cefoperazone / sulbactam,aztreonam, imipenem, amikacin, gentamycin, minocycline, chloramphenicol, levofloxacin, ciprofloxacin, and compound sulfamethoxazole) were all higher than nonCRAB isolates( all P≤0.01), Compared with nonCRAB isolates, The resistant rate of CRAB to cefoperazone/sulbactam was the lowest(<15%), followed by minocycline, resistant rates to other antimicrobial agents were all >80.0%. ConclusionSurveillance of CRAB should be further strengthened. It is necessary to focus on the control and prevention of healthcareassociated infection in ICU patients and respiratory system. [Key words]Acinetobacter baumannii; carbapenemase; carbapenemresistant antibiotic; carbapenemresistant Acinetobacter baumannii; drug resistance,microbial;healthcareassociated infection

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鲍群丽,汪宏良,柯俊.耐碳青霉烯类鲍曼不动杆菌临床分布及耐药谱动态观察[J]. 中国感染控制杂志,2015,14(5):311-313. DOI:10.3969/j. issn.1671-9638.2015.05.006.
BAO Qunli, WANG Hongliang, KE Jun. Distribution characteristics and dynamic observation of antimicrobial resistant spectrum of carbapenemresistant Acinetobacter baumannii[J]. Chin J Infect Control, 2015,14(5):311-313. DOI:10.3969/j. issn.1671-9638.2015.05.006.

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  • 收稿日期:2014-04-22
  • 最后修改日期:2014-06-12
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  • 在线发布日期: 2015-05-30
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