CAJ | 학술논문

目的：了解东莞东华医院6年间临床分离鲍曼不动杆菌感染的分布情况及其耐药性变化趋势，为临床合理使用抗菌药物及有效控制感染提供依据。方法对我院2009-2014年临床送检标本进行常规微生物培养、鉴定和药敏试验，并用WHONET 5.6软件统计分析各病区各类标本中鲍曼不动杆菌的分布及耐药性的变化情况。结果于2009-2014年共检出鲍曼不动杆菌1328株，以病房患者呼吸道标本检出为主，为1000株，占75.3%，其次为伤口分泌物，为113株，占8.5%；鲍曼不动杆菌主要分布在ICU、脑外科、神经内科和呼吸内科。鲍曼不动杆菌对临床常用的14种抗菌药物耐药率以及临床分离率总体呈现出上升的势头，其中对亚胺培南和美洛培南的耐药率明显上升，亚胺培南的耐药率从2009年的2.9%上升至2014年的58.6%，美洛培南的耐药率从2009年的0.0%上升至2014年的59.4%；喹诺酮类及三代头孢的耐药率均呈不同幅度上升，且耐药率均大于50%。结论鲍曼不动杆菌耐药性呈上升趋势，耐药形势严峻，应了解临床分离的鲍曼不动杆菌耐药情况，及时监测其耐药现状，研究该菌的流行型别，为临床合理用药及控制医院感染提供依据。
목적：료해동완동화의원6년간림상분리포만불동간균감염적분포정황급기내약성변화추세，위림상합리사용항균약물급유효공제감염제공의거。방법대아원2009-2014년림상송검표본진행상규미생물배양、감정화약민시험，병용WHONET 5.6연건통계분석각병구각류표본중포만불동간균적분포급내약성적변화정황。결과우2009-2014년공검출포만불동간균1328주，이병방환자호흡도표본검출위주，위1000주，점75.3%，기차위상구분비물，위113주，점8.5%；포만불동간균주요분포재ICU、뇌외과、신경내과화호흡내과。포만불동간균대림상상용적14충항균약물내약솔이급림상분리솔총체정현출상승적세두，기중대아알배남화미락배남적내약솔명현상승，아알배남적내약솔종2009년적2.9%상승지2014년적58.6%，미락배남적내약솔종2009년적0.0%상승지2014년적59.4%；규낙동류급삼대두포적내약솔균정불동폭도상승，차내약솔균대우50%。결론포만불동간균내약성정상승추세，내약형세엄준，응료해림상분리적포만불동간균내약정황，급시감측기내약현상，연구해균적류행형별，위림상합리용약급공제의원감염제공의거。
Objective To study the distribution and antibiotic resistance tendency of Acinetobacter baumannii in clinical specimens from 2009 to 2014 in our hospital, in order to provide referrence for appropriate use of antibiotics in clinic and to help carrying on the prevention and control of infection. Methods Clinical specimens from our hospi-tal during 2009 to 2014 were collected for conventional microbiological culture, identification and antimicrobial sensitiv-ity test. The distribution and antibiotic resistance tendency of A. baumannii were analyzed using WHONET 5.6 software. Results A total of 1 328 strains of A. baumannii were isolated, mainly from respiratory tract specimens (1 000 strains, accounting for 75.3%), followed by wound secretion (113 strains, accounting for 8.5%). A. baumannii mainly distributed in ICU, Department of Cerebral Surgery, Department of Neurology, and Department of Respiratory Medicine. The clini-cal detection rate and the antimicrobial resistance of A. baumannii to commonly used 14 antibiotics were on the rise gen-erally. The drug resistance rates to Imipenem and Meropenem were increased significantly, from 2.9%and 0.0%in 2009 to 58.6%and 59.4%in 2014, respectively. The resistances to quinolones and third generation cephalosporin increased to different degrees, and the resistant rates were both more than 50%. Conclusion The drug resistance of A. baumannii is on the rise. Considering the serious situation, we should understand the clinical drug resistance situation of A. baumannii and timely monitor the resistance status, in order to provide basis for rational drug use and control of hospital infection.