目的 探討河南中醫(yī)藥大學(xué)第三附屬醫(yī)院心血管疾病住院患者鮑曼不動(dòng)桿菌感染的分布及耐藥情況，為臨床治療提供指導(dǎo)性意見(jiàn)。方法 選取河南中醫(yī)藥大學(xué)第三附屬醫(yī)院心血管內(nèi)科2011年1月—2017年12月確診的醫(yī)院感染性鮑曼不動(dòng)桿菌患者103例，統(tǒng)計(jì)分析發(fā)生感染患者的疾病分布、標(biāo)本來(lái)源及其耐藥情況。結(jié)果 共分離出103株鮑曼不動(dòng)桿菌，其中住院患者原患疾病主要為急性心肌梗死（43.69%）和冠心病(20.39%)；標(biāo)本來(lái)源依次為晨痰及下呼吸道分泌物、胸水、血液、尿液；鮑曼不動(dòng)桿菌對(duì)磺胺甲（口惡）唑/甲氧芐啶、奈替米星的耐藥率均在60%以上，對(duì)頭孢他啶、環(huán)丙沙星的耐藥率均在50%以上；對(duì)阿米卡星、美羅培南、亞胺培南、米諾環(huán)素的耐藥率均在20%～30%。結(jié)論 鮑曼不動(dòng)桿菌對(duì)阿米卡星、美羅培南、亞胺培南、米諾環(huán)素的耐藥率相對(duì)較低，臨床上應(yīng)根據(jù)藥敏結(jié)果合理用藥。

Objective To investigate the distribution and drug resistance of Acinetobacter baumannii infection in hospitalized patients with cardiovascular diseases in Third Affiliated Hospital of Henan University of Traditional Chinese Medicine, and provide guidance for clinical treatment. Methods Patients (103 cases) with hospital-infected A. baumannii in Department of Cardiovascular of Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2011 to December 2017 were selected, and the distribution of infected patients, the source of specimens, and drug-resistance situation were analyzed. Results A total of 103 strains of A. baumannii were isolated. The main original disease of inpatients were acute myocardial infarction (43.69%) and coronary heart disease (20.39%). Specimens source of A. baumannii were followed by morning and lower respiratory secretions, pleural effusion, blood, and urine. The resistance rates of A. baumannii against azole/methoxyoxidine and netilmicin were all above 60%, and the resistance rates against ceftazidime and ciprofloxacin were more than 50%. The resistance rates of A. baumannii against amikacin, meropenem, imipenem, and minocycline were 20% - 30%. Conclusion The resistance rate of A. baumannii against amikacin, meropenem, imipenem, and minocycline is relatively lower, and rational drug use should be made according to the results of drug sensitivity.

河南省科技廳項(xiàng)目（162300410097）