CAJ | 학술논문

目的对2012-2014年鲍曼不动杆菌(AB)的分离情况及耐药性变迁进行分析,指导临床合理用药.方法回顾性分析2012年1月至2014年12月自内蒙古自治区人民医院分离出的738株AB的标本来源、病区分布和耐药性;对比分析耐亚胺培南AB (1RAB)和亚胺培南敏感AB(ISAB)的耐药性差异.结果 AB的病区来源主要为重症监护病房(ICU)[48.4％(357/738)]和神经内科[13.0％ (96/738)];全院IRAB的检出率为79.3％(585/738),其中ICU的检出率高达96.6％(345/357).AB和IRAB的标本来源主要为痰液,分别占80.5％(594/738)和82.1％ (480/585).AB除对阿米卡星27.4％ (202/738)和复方新诺明39.0％(288/738)的耐药率较低外;对其他11种抗菌药物的耐药率均较高,其中对哌拉西林钠他唑巴坦钠、盐酸头孢吡肟和亚胺培南的耐药率分别为77.8％(574/738)、81.7％(603/738)和79.3％(585/738);2012、2013和2014年对复方新诺明的耐药率分别为68.2％(148/217)、27.1％(73/269)和26.6％(67/252),呈逐年递减趋势.IRAB对阿米卡星和复方新诺明的耐药率为29.6％(173/585)和42.9％ (251/585),对其他10种抗菌药物的耐药率达91.6％～ 100.0％;ISAB对哌拉西林钠他唑巴坦钠和阿米卡星的耐药率较低,分别为3.3％(5/153)和6.5％ (10/153),对其他10种抗菌药物的耐药率为12.4％～ 25.5％,相对也较低.ISAB对12种抗菌药物的耐药率均明显低于IRAB,差异有统计学意义(P＜0.05).结论内蒙古自治区人民医院AB和IRAB的分离率和耐药性较高;AB对复方新诺明的耐药率呈逐年递减趋势.
목적 대2012-2014년포만불동간균(AB)적분리정황급내약성변천진행분석,지도림상합리용약.방법 회고성분석2012년1월지2014년12월자내몽고자치구인민의원분리출적738주AB적표본래원、병구분포화내약성;대비분석내아알배남AB (1RAB)화아알배남민감AB(ISAB)적내약성차이.결과 AB적병구래원주요위중증감호병방(ICU)[48.4％(357/738)]화신경내과[13.0％ (96/738)];전원IRAB적검출솔위79.3％(585/738),기중ICU적검출솔고체96.6％(345/357).AB화IRAB적표본래원주요위담액,분별점80.5％(594/738)화82.1％ (480/585).AB제대아미잡성27.4％ (202/738)화복방신낙명39.0％(288/738)적내약솔교저외;대기타11충항균약물적내약솔균교고,기중대고랍서림납타서파탄납、염산두포필우화아알배남적내약솔분별위77.8％(574/738)、81.7％(603/738)화79.3％(585/738);2012、2013화2014년대복방신낙명적내약솔분별위68.2％(148/217)、27.1％(73/269)화26.6％(67/252),정축년체감추세.IRAB대아미잡성화복방신낙명적내약솔위29.6％(173/585)화42.9％ (251/585),대기타10충항균약물적내약솔체91.6％～ 100.0％;ISAB대고랍서림납타서파탄납화아미잡성적내약솔교저,분별위3.3％(5/153)화6.5％ (10/153),대기타10충항균약물적내약솔위12.4％～ 25.5％,상대야교저.ISAB대12충항균약물적내약솔균명현저우IRAB,차이유통계학의의(P＜0.05).결론 내몽고자치구인민의원AB화IRAB적분리솔화내약성교고;AB대복방신낙명적내약솔정축년체감추세.
Objective To analyze the isolation condition and variation of drug resistance to acinetobacter baumannii (AB) from 2012 to 2014.Methods Totally 738 strains of AB and 585 strains of imipenem resistant AB (IRAB) isolated from January 2012 to December 2012 were retrospectively analyzed.The source of samples,ward distribution and drug resistance were collected.The difference of drug resistance between IRAB and imipenem sensitive AB (ISAB) were compared.Results The main wards of AB were intensive care unit (ICI) [48.4％ (357/738)] and department of neurology [13.0％ (96/738)].The total detection rate of IRAB was 79.3％ (585/738),and the detection rate of IRAB in ICU was up to 96.6％ (345/357).The source of samples was sputum for both AB and IRAB [80.5％ (594/738) and 82.1％ (480/585),respectively].The resistance rate of AB to amikacin was relatively low,being 27.4％ (202/738);the resistance rates to the other 11 kinds of antibiotics were high,for example,was 77.8％ (574/738) to piperacillin tazobactam,was 81.7％ (603/738) to cefepime and was 79.3％ (585/738) to imipenem;the resistance rate of AB to compound sulfamethoxazole was gradually decrease year by year [2012:68.2％ (148/217),2013:27.1％ (73/269),2014:26.6％ (67/252)].The resistance rates of IRAB to amikacin and compound sulfamethoxazole were 29.6％ (173/585) and 42.9％ (251/585),the resistance rates to the other 10 kinds of antibiotics were up to 91.6％-100.0％.The resistance rates of ISAB to piperacillin tazobactam and amikacin were low,being 3.3％ (5/153) and 6.5％ (10/153),the resistance rates to the other 10 kinds of antibiotics were also low,being 12.4％-25.5％.The resistance rates of ISAB to 12 kinds of antibiotics were all significantly lower than those of IRAB (P ＜ 0.05).Conclusions The isolation rate and resistance rate of AB and IRAB are high;the drug resistance rate of AB to compound sulfamethoxazole is decreased year by year.