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目的分析鲍曼不动杆菌(Ab)临床分布及耐药情况。方法收集2012年1月—2016年10月深圳市宝安区中心医院住院部分离非重复性Ab 186株,分析其临床分布、耐药情况及耐药基因。结果 Ab主要来自痰标本占75.7%,其次为分泌物标本占13.4%。感染科室分布以重症监护室(ICU)最多,占5.9%,其次为呼吸内科占18.8%。Ab对多黏菌素和头孢哌酮/舒巴坦的敏感性高,分别是100.0%和58.1%,其次是米诺环素为46.8%。186株Ab耐药基因ParC阳性率为92.5%,aac(6’)-Ⅰ为87.6%,Gyr A为87.6%,CTX-M-9为69.9%、SHV为72.6%、TEM为65.1%和OXA-23为72.6%。结论 Ab已成为医院感染的重要致病菌,多药耐药现象严重,耐药机制复杂,医院应加强对该菌的监测,以指导临床合理用药。
Objective To analyze the clinical distribution and drug resistance of Acinetobacter baumannii (Ab). Methods From January 2012 to October 2016, non-repetitive Ab 186 inpatients were recruited from Shenzhen Baoan Central Hospital to analyze their clinical distribution, drug resistance and resistance genes. Results Ab mainly from sputum specimens accounted for 75.7%, followed by secretion specimens accounted for 13.4%. Distribution of infection departments to intensive care unit (ICU) up, accounting for 5.9%, followed by respiratory medicine accounted for 18.8%. The sensitivity of Ab to colistin and cefoperazone / sulbactam was 100.0% and 58.1%, respectively, followed by 46.8% for minocycline. The positive rates of ParC in 186 isolates were 92.5%, 87.6% for aac (6 ’) - Ⅰ, 87.6% for Gyr A, 69.9% for CTX-M-9, 72.6% for SHV, 65.1% for TEM and 65.1% for OXA -23 is 72.6%. Conclusion Ab has become an important pathogen of nosocomial infections. The multidrug resistance is serious and the mechanism of drug resistance is complicated. The hospital should strengthen the monitoring of the bacteria to guide clinical rational drug use.