目的 分析西安交通大學(xué)第二附屬醫(yī)院鮑曼不動桿菌的臨床分布及耐藥性，為臨床醫(yī)師選擇合理的抗感染治療方案提供參考依據(jù)。方法 以2018年1月-2019年12月西安交通大學(xué)第二附屬醫(yī)院住院的患者為研究對象，按照美國臨床實驗室標(biāo)準(zhǔn)化委員會（CLSI）推薦的方法進(jìn)行鮑曼不動桿菌的初步篩選，用梅里埃VITEK 2 Compact全自動細(xì)菌鑒定及藥敏分析系統(tǒng)進(jìn)行細(xì)菌鑒定和藥敏實驗，用Excel進(jìn)行數(shù)據(jù)統(tǒng)計分析。結(jié)果 2018-2019年本院住院患者中共分離出935株鮑曼不動桿菌，主要分布于急診科，共181株；主要來源于痰液標(biāo)本，共676株。感染人群主要為14歲以上的中青年及老年患者。藥敏結(jié)果顯示鮑曼不動桿菌對替卡西林/克拉維酸、多西環(huán)素、哌拉西林/他唑巴坦具有較高的耐藥性，耐藥率依次為87.43%、75.96%、64.98%；鮑曼不動桿菌對黏菌素、阿米卡星和替加環(huán)素具有良好的敏感性，敏感率依次為99.61%、85.02%、73.56%。結(jié)論 本院臨床上鮑曼不動桿菌感染的高發(fā)人群為14歲以上的中青年及老年患者，鮑曼不動桿菌對多種抗生素都有很強的耐藥性，應(yīng)加強病原菌培養(yǎng)及耐藥性監(jiān)測，指導(dǎo)臨床醫(yī)師合理使用抗生素。

Objective To analyze the clinical distribution and changes of drug resistance of Acinetobacter baumannii, so as to provide references for clinician to use the antibiotics reasonablely. Methods The patients in the Second Affiliated Hospital of Xi'an Jiaotong University from January 2018 to December 2019 were collected to study. The preliminary screening of A. baumannii were conducted according to the guideline of CLSI. VITEK 2 Compact was used to analyze the bacteria identification and drug sensitivity test, and Excel were used for statistical analysis. Results From 2018 to 2019, 935 strains of A. baumannii were isolated, mainly distributed in the Department of Emergency; The A. baumannii strains were mostly isolated from sputum samples. The infected people were mainly young, middle-aged and elderly patients over 14 years old. The susceptibility tests showed that the A. baumannii had higher resistance rate to ticarcillin/clavulanic acid, doxycycline and piperacillin/tazobactam were 87.43%, 75.96%, and 64.98%, respectively. A. baumannii showed the excellent sensitive activity to colistin, amikacin and tigecycline with the drug sensitivity rate of 99.61%, 85.02%, and 73.56%, respectively. Conclusions The A. baumannii strains were mainly isolated from patients over 14 years old, a variety of antibiotics have strong resistance. More attention should be paid on the bacterial culture and the monitoring of the drug resistance to direct clinical rational use of antibiotics for patients.

R978.1

陜西省重點研發(fā)計劃項目（2020SF-173）；西安交通大學(xué)第二附屬醫(yī)院科研基金自由探索項目［YJ（ZYTS）2019003］