CAJ | 학술논문

目的：分析华润武钢总医院2007年1月至2012年12月期间鲍曼不动杆菌（ABA）临床分离株的分布及耐药情况，为临床合理使用抗菌药物提供科学依据。方法采用 API 微生物培养鉴定系统对临床各科送检标本进行 ABA 培养、鉴定及药敏分析，通过 WHONET5．6软件分析菌株的耐药性。结果近6年来，本院共分离出 ABA 791株，ABA 在病原菌中的分离率为7．8％。ABA 检出以痰液（80．4％）及咽拭子（10．9％）标本为主，该菌株临床分布比较广泛，重症监护病房（18．8％）、干部病房（17．6％）、呼吸内科（13．3％）和神经外科（12．3％）的患者感染率较高。2007～2012年耐药率小于50％的抗菌药物包括亚胺培南和头孢哌酮钠/舒巴坦，大多数抗菌药物耐药性有升高的趋势，尤其对亚胺培南的耐药率升高最为明显。结论ABA 耐药情况较为严重，2007～2012年 ABA 临床分离株对大多数抗菌药物耐药性有升高的趋势，动态监测该菌的分布及耐药情况变迁，有助于指导临床合理使用抗菌药物，防止医院内感染，减少耐药菌株的产生。
목적：분석화윤무강총의원2007년1월지2012년12월기간포만불동간균（ABA）림상분리주적분포급내약정황，위림상합리사용항균약물제공과학의거。방법채용 API 미생물배양감정계통대림상각과송검표본진행 ABA 배양、감정급약민분석，통과 WHONET5．6연건분석균주적내약성。결과근6년래，본원공분리출 ABA 791주，ABA 재병원균중적분리솔위7．8％。ABA 검출이담액（80．4％）급인식자（10．9％）표본위주，해균주림상분포비교엄범，중증감호병방（18．8％）、간부병방（17．6％）、호흡내과（13．3％）화신경외과（12．3％）적환자감염솔교고。2007～2012년내약솔소우50％적항균약물포괄아알배남화두포고동납/서파탄，대다수항균약물내약성유승고적추세，우기대아알배남적내약솔승고최위명현。결론ABA 내약정황교위엄중，2007～2012년 ABA 림상분리주대대다수항균약물내약성유승고적추세，동태감측해균적분포급내약정황변천，유조우지도림상합리사용항균약물，방지의원내감염，감소내약균주적산생。
Objective To analyze the clinical distribution and drug resistance of clinically isolated strains of Acinetobacter Bau-mannii(ABA)in our hospital from January 2007 to December 2012 so as to provide the basis for the rational use of antibacterial drugs in clinic.Methods The API microbiological culture and identification system was adopted to conduct the ABA culture,identi-fication and drug susceptibility analysis on the clinical specimens submitted by various clinical department and the drug resistance of the strains was analyzed by using WHONET5.6 software.Results 791 strains of ABA were isolated in the recent 6 years,and the isolating rate of ABA in the pathogenic bacteria was 7.8%;The ABA detection was dominated by the sputum (80.4%)and the throat swab(10.9%)specimens;the distribution of isolated ABA strains were relatively widespread;the infection rates of the pa-tients were higher in ICU (18.8%),cadre wards(17.6%),respiratory medicine department(13.3%)and neurosurgery department (12.3%).During these 6 years,the drug resistance rate of less than 50% included imipenem(IPM)and cefoperazone sodium/sul-bactam,and the resistance rate in most of commonly used antibacterial drugs showed an increasing trend,especially IPM.Conclusion The drug resistance of ABA is more serious and the resistance rate of clinically isolated strains to most of antibacterial drugs in our hospital during 2007- 2012 showed an increasing trend.Dynamically monitoring the ABA distribution and the drug resistance changes conduces to guide the rational use of antibacterial drugs in clinic,prevent the nosocomial infection and reduce the generation of pan-drug resistant strains.