ICU鲍曼不动杆菌感染的流行状况及耐药性分析

目的对ICU住院患者鲍曼不动杆菌感染的流行状况及耐药情况进行调查,为临床合理选用抗菌药物提供参考。方法对2012年7月至2013年12月ICU住院患者送检的693份各种临床标本进行病原菌的分离鉴定,对分离出的鲍曼不动杆菌采用K-B法做体外药敏试验。结果 693份临床标本共分离出110株鲍曼不动杆菌,其中多重耐药菌株有103株（93.6%）,感染的标本来源以痰液最为常见（86.4%）。鲍曼不动杆菌对常用抗菌药物耐药广泛,对氨苄西林、头孢唑啉100%耐药,对哌拉西林、头孢曲松、复方新诺明、氨曲南、环丙沙星、头孢吡肟、哌拉西林/他唑巴坦及庆大霉素等多种抗菌药物的耐药率大于80.0%。结论 ICU患者鲍曼不动杆菌感染多由多重耐药菌株引起,感染部位以下呼吸道为主,其对抗菌药物耐药情况相当严峻,加强耐药性监测及合理使用抗菌药物,对减少耐药菌株的产生具有重要意义。

The distribution and drug resistance of Acinetobacter baumann from ICU inpatients

Objective To investigate the distribution and drug resistance of Acinetobacter baumann from ICU inpatients,and provide reference for reasonable use of antiviral medicines. Methods 693 clinical specimens of ICU inpatients from July 2012 to December 2013 were identified for pathogenic isolation. In vitro drug sensitivity test was performed on the Acinetobacter baumann isolates using K-B methodology. Results From the 693 clinical specimens,110 Acinetobacter baumann strains were isolated,including 103 multiple-resistant strains（ 93. 6% of all Acinetobacter baumann）. Most of the pathogens was isolated from stputa（ 86. 4%）. The Acinetobacter baumann was resistant to common antibacterial medicines including Ampicillin and Cafazolin（ 100%）,Piperacillin,Ceftriaxone,Rimethoprim-sulfamethoxazole,Aztreonam,Ciprofloxacin,Cefepime,Piperacillin /tazabactam,and Gentamycin（ over80. 0%）. Conclusion The Acinetobacter baumann infections in ICU are usually caused by multiple-resistant strains,which infect mainly lower respiratory tract. It is an of important significance to strengthen the monitoring of the resistance and reasonably use antibacterial medicines to reduce the occurrence of drug resistant strains.