264株鲍曼不动杆菌的临床分布及耐药性分析(1)
[摘要]目的 了解锦州市中心医院鲍曼不动杆菌的临床分布及其耐药情况，为临床治疗鲍曼不动杆菌的感染提供参考依据。方法 应用VITEK-2 Compact鉴定系统对2014年1月～2015年12月分离出的鲍曼不动杆菌进行细菌鉴定和药敏分析，采用WHONET 5.6软件对药敏结果进行统计分析。结果 本院共分离出鲍曼不动杆菌264株，主要标本来源为痰液，共检出212株(80.3%)，其次是尿液28株(10.6%)。主要分布科室为呼吸科(检出89株，占33.7%)以及重症监护科(检出72株，占27.3%)，其次是内分泌科30株(11.4%)。对头孢哌酮/舒巴坦的敏感率为78.7%，对氨苄西林/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南的敏感率分别为39.9%、33.3%、33.3%和39.6%。对妥布霉素、头孢他啶、头孢吡肟、庆大霉素、阿米卡星、环丙沙星和复方新诺明的敏感率均<30.0%。结论 本院临床分离的鲍曼不动杆菌主要来源于痰标本，多分布于呼吸科和重症监护科，其中对头孢哌酮/舒巴坦的敏感率最高。
[关键词]鲍曼不动杆菌；耐药率；抗菌药物；医院感染；泛耐药
[中图分类号] R446.5 [文献标识码] A [文章编号] 1674-4721(2016)07(c)-0121-03
[Abstract]Objective To understand the clinical distribution and drug resistance of Acinetobacter baumannii in Jinzhou Central Hospital，and to provide reference for clinical treatment of infection of Acinetobacter baumannii.Methods Bacterial identification and drug sensitivity analysis were carried out by using VITEK-2 Compact identification system from January 2014 to December 2015，and the results were statistically analyzed by WHONET 5.6 software.Results 264 strains of Acinetobacter baumannii were isolated from our hospital，the main source of sputum samples，a total of 212 strains accounted for 80.3%，followed by the urine of 28 strains (10.6%).The main distribution departments for the department of respiration (89 strains accounted for 33.7%) and intensive care unit (72 strains accounted for 27.3%)，followed by the department of endocrinology (30 strains accounted for 11.4%).Main antibacterial drug susceptibility were sensitive to cefoperazone/sulbactam was 78.7%，the sensitivity rate to ampicillin/sulbactam，piperacillin/tazobactam，imipenem and meropenem was 39.9%，33.3%，33.3% and 39.6% respectively.The sensitive rates of tobramycin，ceftazidime，cefepime，gentamicin，amikacin，ciprofloxacin and SMZ-TMP was lower than 30.0%.Conclusion Acinetobacter baumannii clinical isolated in our hospital comes mainly from sputum specimens，mostly locate in respiratory department and intensive care unit，which to cefoperazone/sulbactam sensitive rate is the highest.
[Key words]Acinetobacter baumannii；Resistant rate；Antibacterials；Nosocomial infection；Pan-drug resistant
鲍曼不动杆菌(Acinetobacter baumannii)属于需氧非发酵革兰阴性杆菌，是不动杆菌属中最常见的一种革兰阴性杆菌，其广泛存在于自然界的水、土壤、医院、环境、人体的皮肤表面以及开放性气道中，在体外能够长期存活，主要引起呼吸道及泌尿生殖道感染、继发性脑膜炎、败血症，是临床上常见的条件致病菌[1-3]。近年来，由于临床上大量应用以及部分不合理使用广谱抗菌药物，导致抗菌药物的耐药率不断增强，出现了世界性流行的多重耐药、泛耐药甚至全耐药的鲍曼不动杆菌[4-6]。为了解鲍曼不动杆菌的临床分布特征和耐药性，更好地指导临床医生合理用药，本研究对我院临床分离的264株鲍曼不动杆菌进行了回顾性分析，现报告如下。
1材料与方法
1.1菌株来源 (刘郁)
[关键词]鲍曼不动杆菌；耐药率；抗菌药物；医院感染；泛耐药
[中图分类号] R446.5 [文献标识码] A [文章编号] 1674-4721(2016)07(c)-0121-03
[Abstract]Objective To understand the clinical distribution and drug resistance of Acinetobacter baumannii in Jinzhou Central Hospital，and to provide reference for clinical treatment of infection of Acinetobacter baumannii.Methods Bacterial identification and drug sensitivity analysis were carried out by using VITEK-2 Compact identification system from January 2014 to December 2015，and the results were statistically analyzed by WHONET 5.6 software.Results 264 strains of Acinetobacter baumannii were isolated from our hospital，the main source of sputum samples，a total of 212 strains accounted for 80.3%，followed by the urine of 28 strains (10.6%).The main distribution departments for the department of respiration (89 strains accounted for 33.7%) and intensive care unit (72 strains accounted for 27.3%)，followed by the department of endocrinology (30 strains accounted for 11.4%).Main antibacterial drug susceptibility were sensitive to cefoperazone/sulbactam was 78.7%，the sensitivity rate to ampicillin/sulbactam，piperacillin/tazobactam，imipenem and meropenem was 39.9%，33.3%，33.3% and 39.6% respectively.The sensitive rates of tobramycin，ceftazidime，cefepime，gentamicin，amikacin，ciprofloxacin and SMZ-TMP was lower than 30.0%.Conclusion Acinetobacter baumannii clinical isolated in our hospital comes mainly from sputum specimens，mostly locate in respiratory department and intensive care unit，which to cefoperazone/sulbactam sensitive rate is the highest.
[Key words]Acinetobacter baumannii；Resistant rate；Antibacterials；Nosocomial infection；Pan-drug resistant
鲍曼不动杆菌(Acinetobacter baumannii)属于需氧非发酵革兰阴性杆菌，是不动杆菌属中最常见的一种革兰阴性杆菌，其广泛存在于自然界的水、土壤、医院、环境、人体的皮肤表面以及开放性气道中，在体外能够长期存活，主要引起呼吸道及泌尿生殖道感染、继发性脑膜炎、败血症，是临床上常见的条件致病菌[1-3]。近年来，由于临床上大量应用以及部分不合理使用广谱抗菌药物，导致抗菌药物的耐药率不断增强，出现了世界性流行的多重耐药、泛耐药甚至全耐药的鲍曼不动杆菌[4-6]。为了解鲍曼不动杆菌的临床分布特征和耐药性，更好地指导临床医生合理用药，本研究对我院临床分离的264株鲍曼不动杆菌进行了回顾性分析，现报告如下。
1材料与方法
1.1菌株来源 (刘郁)