2009-2011年AIDS住院患者多重耐药菌感染调查及耐药性分析

目的了解某院获得性免疫缺陷综合征（AIDS）住院患者的多重耐药菌分布特点及耐药情况，为临床治疗提供依据。方法对2009-2011年住院的AIDS患者各类标本分离的426株多重耐药菌药敏试验结果，应用WHONET5.4软件进行统计分析。结果分离的多重耐药菌包括产超广谱β 内酰胺酶（ESBLs）肠杆菌科细菌213株，耐甲氧西林金黄色葡萄球菌（MRSA）41株，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）21株，多重耐药鲍曼不动杆菌（MDR AB）79株和多重耐药铜绿假单胞菌(MDR PA)72株。检出的产ESBLs肠杆菌科细菌除对少数广谱抗菌药物比较敏感外，对大部分抗菌药物存在不同程度的耐药（耐药率3.74%~100%）。结论住院AIDS患者分离的多重耐药菌以肠杆菌科细菌多见，耐药率高，临床医生应谨慎选用抗菌药物进行经验治疗；同时应加强监测，避免多重耐药菌感染在医院暴发流行。

Multidrug resistance bacterial infection and antimicrobial resistance in AIDS inpatients during 2009-2011

Objective To study the distribution and drug-resistance of multidrug-resistant bacteria（MDRB） from inpatients with acquired immunodeficiency syndrome （AIDS）, so as to provide reference for clinical therapy. Meth- ods Antimicrobial susceptibility testing result of 426 MDRB isolates from .AIDS inpatients during 2009 - 2011 was analyzed by WHONET 5.4 software. Results The isolated MDt included 213 isolates of extended-spectrum lactamaseproducing Enterobacteriaceae bacteria, 41 methicillin-resistant Staphylococcus aureus （MRSA）, 21 methicil lin-resistant coagulase negative Staphylococcus （MRCNS）, 79 MDR-Acinetobacter baumannii （MDR-AB）, and 72 MDR-Pseudomonas aeruginosa （MDR-PA）. Except lower drug-resistance rate to a minority of broad spectrum anti- microbial agents, ESBL-producing Enterobacteriaceae bacteriaca had higher resistance rates （3. 74% - 100%） to other antimicrobial agents. Conclusion The major MDRB from AIDS inpatients is Enterobacteriaceae bacteria, clini- cians should choose antimicrobial agents for empirical treatment, surveillance should be intensified, so as to avoid the outbreak of MDR infection in hospital.