目的 分析西安交通大学第二附属医院鲍曼不动杆菌的临床分布及耐药性，为临床医师选择合理的抗感染治疗方案提供参考依据。方法 以2018年1月-2019年12月西安交通大学第二附属医院住院的患者为研究对象，按照美国临床实验室标准化委员会（CLSI）推荐的方法进行鲍曼不动杆菌的初步筛选，用梅里埃VITEK 2 Compact全自动细菌鉴定及药敏分析系统进行细菌鉴定和药敏实验，用Excel进行数据统计分析。结果 2018-2019年本院住院患者中共分离出935株鲍曼不动杆菌，主要分布于急诊科，共181株；主要来源于痰液标本，共676株。感染人群主要为14岁以上的中青年及老年患者。药敏结果显示鲍曼不动杆菌对替卡西林/克拉维酸、多西环素、哌拉西林/他唑巴坦具有较高的耐药性，耐药率依次为87.43%、75.96%、64.98%；鲍曼不动杆菌对黏菌素、阿米卡星和替加环素具有良好的敏感性，敏感率依次为99.61%、85.02%、73.56%。结论 本院临床上鲍曼不动杆菌感染的高发人群为14岁以上的中青年及老年患者，鲍曼不动杆菌对多种抗生素都有很强的耐药性，应加强病原菌培养及耐药性监测，指导临床医师合理使用抗生素。

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

陕西省重点研发计划项目（2020SF-173）；西安交通大学第二附属医院科研基金自由探索项目［YJ（ZYTS）2019003］