CAJ | 학술논문

目的：了解南京医科大学第一附属医院2012~2014年鲍曼不动杆菌(acinetobacter baumanmii，AB)的临床分布特点及耐药性变迁。方法：细菌鉴定采用VITEK-2 Compact全自动细菌鉴定仪；药物敏感试验采用纸片琼脂扩散法(K-B法)；耐药率比较运用SPSS 19.0软件处理；菌株分布及药敏结果以WHONET5.6软件进行分析。结果：2012~2014年，AB临床分离率分别为13.7%、11.5%、12.2%，分离率超过铜绿假单胞菌，仅次于大肠埃希菌。AB主要来源于呼吸道标本(79.2%)，专业分布主要为重症监护病房(intensive care unit，ICU，44.6%)、外科(28.4%)、内科(22.5%)。AB对临床常用抗菌药物均呈现了很高的耐药性，大多数药物耐药率在70.0%以上，耐药率较低的药物有米诺环素(43.4%~55.8%)、阿米卡星(50.1%~58.4%)，2013、2014年AB耐药率较2012年及以往资料有下降趋势。不同标本及专业来源的AB耐药性存在差异。结论：AB已成为引起临床感染的最常见非发酵菌，多引起呼吸系统感染，对常用抗菌药物耐药率高，但已有下降趋势，应继续规范抗菌药物的使用。
목적：료해남경의과대학제일부속의원2012~2014년포만불동간균(acinetobacter baumanmii，AB)적림상분포특점급내약성변천。방법：세균감정채용VITEK-2 Compact전자동세균감정의；약물민감시험채용지편경지확산법(K-B법)；내약솔비교운용SPSS 19.0연건처리；균주분포급약민결과이WHONET5.6연건진행분석。결과：2012~2014년，AB림상분리솔분별위13.7%、11.5%、12.2%，분리솔초과동록가단포균，부차우대장애희균。AB주요래원우호흡도표본(79.2%)，전업분포주요위중증감호병방(intensive care unit，ICU，44.6%)、외과(28.4%)、내과(22.5%)。AB대림상상용항균약물균정현료흔고적내약성，대다수약물내약솔재70.0%이상，내약솔교저적약물유미낙배소(43.4%~55.8%)、아미잡성(50.1%~58.4%)，2013、2014년AB내약솔교2012년급이왕자료유하강추세。불동표본급전업래원적AB내약성존재차이。결론：AB이성위인기림상감염적최상견비발효균，다인기호흡계통감염，대상용항균약물내약솔고，단이유하강추세，응계속규범항균약물적사용。
Objective:To investigate the clinical distribution and drug resistance of pathogens of acinetobacter baumannii (AB) strains isolated from the First Affiliated Hospital of Nanjing Medical University from 2012 to 2014. Methods:Automatic detection machine of VITEK-2 compact was used for identification of bacteria, as well as the drug susceptibility of the AB was performed by using disc agar diffusion (K-B method). All data were analyzed by WHONET5.6 or SPSS 19.0. Results:From 2012 to 2014, the separation rates of AB were 13.7%, 11.5%and 12.2%, respectively, higher than pseudomonas aeruginosa, lower only to Escherichia coli. hTe AB were mainly isolated from the department of intensive care unit (ICU, 44.6%), surgery (28.4%), and internal medicine (22.5%). A total of 79.2%isolates were from the respiratory tract specimens. hTe resistance rates to many kinds of antibiotics of AB strains were higher than 70.0%. hTe lower resistance rates of the AB to minocycline, amikacin, were 43.4%~55.8%and 50.1%~58.4%, respectively. hTere was a decrease in trend percentages during three years from 2012 to 2014. hTere were differences among the resistance rates of the AB isolated from different specimens and different departments. Conclusion:AB had been the most frequent non-fermentative pathogen causing clinical infection and the respiratory tract infection was dominant. hTough AB was highly resistance rate to clinical antibiotics, it had a downward trend. hTe use of antimicrobial drugs should continue to standardize.