探讨器官移植患者鲍曼不动杆菌感染的药敏情况。

回顾性分析2012年6月至2015年6月在中山大学附属第三医院检出鲍曼不动杆菌感染的66例患者临床资料。所有患者均签署知情同意书，符合医学伦理学规定。其中男55例，女11例；平均年龄（47±12）岁。患者中包括肝移植术前11例，肝移植术后52例，肾移植术后1例，肝移植状态2例。收集患者痰液、尿液、血液、伤口分泌物、引流液行细菌培养及药敏试验。

从66例患者的标本中培养出73株鲍曼不动杆菌，对13种抗生素的耐药率分别为：哌拉西林钠78%，头孢噻肟钠75%，头孢他啶74%，头孢曲松钠73%，头孢吡肟74%，美罗培南/亚胺培南-西司他丁钠73%，替卡西林钠-克拉维酸钾75%，环丙沙星73%，左氧氟沙星71%，妥布霉素73%，庆大霉素73%，阿米卡星73%，甲氧苄胺嘧啶/磺胺嘧啶69%。2014年和2015年培养出的鲍曼不动杆菌对于上述抗生素的耐药率均高于2012年和2013年。其中对碳氢酶稀类抗生素的耐药率2012年为17%，2013年为33%，2014年升至86%，2015年的耐药率高达92%。

目前器官移植患者多重耐药鲍曼不动杆菌感染的发生率有逐年升高趋势，需要在治疗中加以重视。

To investigate the drug sensitivity of Acinetobacter baumannii in organ transplantation patients.

Clinical data of 66 patients detected with Acinetobacter baumannii in the Third Affiliated Hospital of Sun Yat-sen University between June 2012 and June 2015 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 66 patients, 55 were males and 11 were females with the average age of (47±12) years old. Among the 66 patients, 11 cases were before liver transplantation, 52 were after liver transplantation, 1 was after kidney transplantation and 2 were in liver transplantation state. Sputum, urine, blood, wound secretion and drainage liquid of the patients were collected for bacterial culture and drug sensitivity test.

A total of 73 strains of Acinetobacter baumannii cultured from the specimens of 66 patients and the drug resistance rate to 13 antibiotics was respectively 78% to piperacillin sodium, 75% to cefotaxime sodium, 74% to ceftazidime, 73% to ceftriaxone sodium, 74% to cefepime, 73% to meropenem/imipenem-cilastatin sodium, 75% to ticarcillin sodium-clavulanate potassium, 73% to ciprofloxacin, 71% to levofloxacin, 73% to tobramycin, 73% to gentamycin, 73% to amikacin and 69% to trimethoprim/sulfadiazine. The resistance rate of Acinetobacter baumannii cultured between 2014 and 2015 to the aforementioned antibiotics was higher than that cultured between 2012 and 2013. The resistance rate to carbapenems was 17% in 2012, 33% in 2013, 86% in 2014 and 92% in 2015.

The infection incidence of multi-drug resistant Acinetobacter baumannii in organ transplantation patients trends to increase year by year, which shall be paid attention to during the treatment.