摘要
目的了解医院感染鲍氏不动杆菌的临床科室分布、耐药性变化及常见抗菌药物的使用情况,为临床合理选用抗菌药物提供依据。方法采用纸片扩散法进行抗菌药物敏感试验,采用限定日剂量(DDD)、用药频度(DDDs)等指标,按季度对抗菌药物的使用情况进行分析。结果全年共检出鲍氏不动杆菌796株,ICU检出506株,占63.6%,居第1位;鲍氏不动杆菌对头孢吡肟、哌拉西林、左氧氟沙星等10种抗菌药物耐药率第一季度>90.0%,后3个季度<90.0%,平均下降18.9%;对头孢噻肟、氨曲南、庆大霉素耐药率50.0%～90.0%;对阿米卡星、妥布霉素耐药率<20.0%;对多黏菌素B耐药率为0;左氧氟沙星、头孢吡肟和哌拉西林/舒巴坦DDDs排序一直保持在前3位;阿米卡星DDDs增长明显,后3个季度平均比第一季度增长380.3%;头孢噻肟DDDs第四季度只占全年度的0.4%。结论鲍氏不动杆菌对多数抗菌药物的耐药率均较高,整体上呈现耐药率逐渐下降又反弹的季度波动规律;应对ICU等重点感染科室加强用药监控,减少细菌耐药产生。
OBJECTIVE To understand the distribution of Acinetobacter baumannii causing nosocomial infections in the clinical departments and analyze the change of drug resistance to the commonly used antibiotics so as to guide the reasonable clinical use of antibiotics. METHODS The drug susceptibility testing was performed with the use of disk diffusion method, and the use of antibiotics in different quarters was analyzed through the determination of the indicators such as the defined daily dose （DDD） and medication frequency （DDDs）. RESULTS A total of 796 strains of A. baumannii have been isolated in the whole year, among which 506 （63. 6%） strains were isolated from the ICU, ranking the first place. The drug resistance rates of the A. baumannii to cefepirne, piperacillin; and levofloxacin were more than 90. 0% in the first quarter, less than 90. 0% in the rest three quarters, with an average decrease of 18.9%; the drug resistance rates to cefotaxime, aztreonam, and gentamicin ranged from 50% to 90%; the drug resistance rates to amikacin and tobramycin were less than 20.0%; the drug resistance rate to polymyxin B was 0. The DDDs of levofloxacin, cefepime and piperacillin-sulbactam ranked the top three places, the DDDs of amikacin increased significantly, with an increase by 380.3% in the last three quarters as compared with that of the first quarter; the DDDs of cefotaxime in the fourth quarter only accounted for 0.4% of the whole year. CONCLUSION A. baumannii strains are highly resistant to most of the antibiotics, the drug resistance rate shows a fluctuation rule that it is decreased gradually at first and then rebounds. The monitoring of medication in the key departments such as ICU should be intensified so as to reduce the bacterial resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第21期5299-5301,共3页
Chinese Journal of Nosocomiology
关键词
鲍氏不动杆菌
耐药性
抗菌药物
Acinetobacter baumannii
Drug resistance
Antibacterial drug
