本文選題：鮑曼不動桿菌 + 多重耐藥��； 參考：《中國感染與化療雜志》2016年04期

【摘要】：目的了解2005-2014年中國主要地區(qū)19所醫(yī)院臨床分離的不動桿菌屬細(xì)菌分布及其耐藥性變化趨勢。方法共收集19所教學(xué)醫(yī)院臨床分離的55 154株不動桿菌屬細(xì)菌,其中鮑曼不動桿菌49 153株。按照統(tǒng)一方案,采用紙片擴(kuò)散法或自動化儀器法進(jìn)行藥敏試驗,按CLSI 2014年版標(biāo)準(zhǔn)判讀藥敏結(jié)果,采用WHONET 5.6軟件進(jìn)行數(shù)據(jù)分析。結(jié)果10年間,不動桿菌屬細(xì)菌的檢出率呈上升趨勢:2005年為10.0%,2014年為11.1%。55 154株不動桿菌屬主要分離自住院患者占92.0%,門急診8.0%。28.5%不動桿菌屬分離自ICU,其次為內(nèi)科病房28.1%。從2005年開始,鮑曼不動桿菌對頭孢菌素類、喹諾酮類、氨基糖苷類藥物的耐藥率均在60%以上,對頭孢哌酮-舒巴坦和亞胺培南的耐藥率較低,分別為28.8%和32.9%。特別從2008年開始,多所醫(yī)院耐藥率明顯增加,多重耐藥菌和廣泛耐藥菌比率也明顯增加。不同醫(yī)院的菌株對抗菌藥物的耐藥率不同,不同科室分離株的耐藥率亦不同,其中以ICU分離株對受試抗菌藥物的耐藥率最高,除頭孢哌酮-舒巴坦和米諾環(huán)素外,對其余受試抗菌藥物的耐藥率在60%以上。結(jié)論從2008以后,鮑曼不動桿菌對氨芐西林-舒巴坦、頭孢哌酮-舒巴坦和米諾環(huán)素的耐藥率逐年增高,特別是對碳青霉烯類藥物耐藥率明顯升高。不同地區(qū)醫(yī)院鮑曼不動桿菌的耐藥率相差較大,不同科室的耐藥率也有很大差異。
[Abstract]:Objective to investigate the distribution and drug resistance of Acinetobacter isolated from 19 hospitals in China from 2005 to 2014. Methods A total of 55,154 strains of Acinetobacter were collected from 19 teaching hospitals, 49,153 of which were Acinetobacter baumannii. According to the unified scheme, the drug sensitivity test was carried out by using disk diffusion method or automatic instrument method. The drug sensitivity results were interpreted according to CLSI 2014 standard, and the data were analyzed by WHONET 5.6 software. Results the positive rate of Acinetobacter bacteria showed an upward trend in ten years: 10.0 in 2005, 11.1 in 2014, 11.1 in 2014, 92.0% in hospitalized patients, 8.0.28.5% in outpatient and emergency department, followed by 28.1in medical ward. Since 2005, the resistance rates of Acinetobacter baumannii to cephalosporins, quinolones and aminoglycosides were all above 60%, and the resistance rates to cefoperazone-sulbactam and imipenem were 28.8% and 32.9%, respectively. Especially since 2008, the rate of drug resistance in many hospitals has increased significantly, and the ratio of multidrug resistant bacteria and widespread drug resistant bacteria has also increased significantly. The antibiotic resistance rates of strains in different hospitals were different, and the drug resistance rates of strains in different departments were also different. The resistance rate of ICU isolates to tested antibiotics was the highest, except for cefoperazone-sulbactam and minocycline. The rate of resistance to other antimicrobial agents was more than 60%. Conclusion after 2008, the resistance rates of Acinetobacter baumannii to ampicillin-sulbactam, cefoperazone-sulbactam and minocycline increased year by year, especially to carbapenems. The drug resistance rate of Acinetobacter baumannii in different hospitals varied greatly, and the resistance rate of Acinetobacter baumannii in different departments was also very different.
【作者單位】： 中國醫(yī)學(xué)科學(xué)院 北京協(xié)和醫(yī)學(xué)院 北京協(xié)和醫(yī)院檢驗科;天津醫(yī)科大學(xué)總醫(yī)院;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院;復(fù)旦大學(xué)附屬華山醫(yī)院;廣州醫(yī)科大學(xué)附屬第一醫(yī)院;中國醫(yī)科大學(xué)附屬第一醫(yī)院;浙江大學(xué)醫(yī)學(xué)院附屬邵逸夫醫(yī)院;安徽醫(yī)科大學(xué)第一附屬醫(yī)院;上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院;新疆醫(yī)科大學(xué)第一附屬醫(yī)院;甘肅省人民醫(yī)院;復(fù)旦大學(xué)附屬兒科醫(yī)院;上海交通大學(xué)附屬兒童醫(yī)院;北京醫(yī)院;昆明醫(yī)科大學(xué)第一附屬醫(yī)院;浙江大學(xué)附屬第一醫(yī)院;四川大學(xué)華西醫(yī)院;內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院;重慶醫(yī)科大學(xué)附屬第一醫(yī)院;
【分類號】：R446.5

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