石佳琪　张翀　刘新　王岚

[摘要] 目的 分析临床分离的376株鲍曼不动杆菌的临床分布及耐药性，为临床感染的诊断与治疗提供依据。方法 2013年9月～2015年7月在沈阳医学院附属中心医院患者送检的各类标本中通过分离培养获得鲍曼不动杆菌376株，采用纸片琼脂扩散法对上述菌株进行药物敏感试验，对其临床分布及药敏结果进行回顾性分析。结果 376株鲍曼不动杆菌大多分离自痰液（83.2%），主要来自于ICU病房（54.0%）；药敏分析结果显示，上述菌株对亚胺培南和美洛培南的敏感率分别达73.4%、64.4%，而对氨曲南的耐药率达83.5%。 结论 鲍曼不动杆菌是医院感染中重要的病原菌，其对抗菌药物的耐药率高，且常表现为多重耐药，临床要重视合理使用抗菌药物，减少多重耐药菌株的产生。

[关键词] 鲍曼不动杆菌；临床分布；耐药性

[中图分类号] R446.5 [文献标识码] A [文章编号] 1674-4721（2016）02（c）-0112-03

[Abstract] Objective To analyze clinical distribution and drug resistance of 376 strains of Acinetobacter baumannii isolated form clinic to provide evidence for diagnosis and treatment of clinical infection. Methods 376 strains of Acinetobacter baumannii isolated from various specimens delivered from Central Hospital Affiliated to Shenyang Medical College from September 2013 to July 2015.These strains were performed drug sensitivity test using agar-diffusion method.The clinical distribution and drug sensitivity results were analyzed retrospectively. Results The majority of these resistant strains were isolated from sputum （83.2%），and distributed in ICU （54.0%）.The result of drug sensitivity analysis showed that the sensitivity rate of above-mentioned strains to imipenem and meropenem was 73.4% and 64.4% respectively，the resistance rate to aztreonam was 83.5%. Conclusion Acinetobacter baumannii is the major pathogenic bacteria in nosocomial infection，and its drug resistance rate is high to antimicrobials，and often displays multiple drug resistance，the rational use of antimicrobials should be valued to reduce multi drug resistant strains.

[Key words] Acinetobacter baumannii；Clinical distribution；Drug resistance

鲍曼不动杆菌（Acinetobacter baumannii，Ab）为革兰氏阴性杆菌，该菌在医院环境中分布广泛且可以长期存活，为条件致病菌，主要引起呼吸道感染，也可引发败血症、泌尿系感染、继发性脑膜炎等[1]。近年来，随着临床上广谱抗菌药物的广泛应用及介入性操作的普及，出现了多重耐药菌株（multidrug resistant Acinetobacter baumanii，MDR-Ab），已对多种抗菌药物普遍耐药[2]，并有逐年上升趋势，给临床抗感染治疗提出了严峻的挑战。为了指导临床及时有效合理地选用抗菌药，本研究回顾性分析了沈阳医学院附属中心医院分离的376株鲍曼不动杆菌的临床分布及其耐药性。

1 材料与方法

1.1 菌株来源

2013年9月～2015年7月沈阳医学院附属中心医院住院患者的痰、血液、尿液、咽拭子等各种标本中分离出鲍曼不动杆菌共376株（去除重复菌株）。……