重症监护病房鲍曼不动杆菌和铜绿假单胞菌的分布及耐药性监测

目的探讨医院重症监护病房(ICU)鲍曼不动杆菌及铜绿假单胞菌临床分离株的分布及耐药性特点。方法回顾性调查2006年7月至2010年6月ICU患者中分离出的鲍曼不动杆菌和铜绿假单胞菌的临床感染情况,对111株鲍曼不动杆菌和73株铜绿假单胞菌的药敏结果进行统计分析,所有数据采用WHONET 5.5软件进行分析。结果鲍曼不动杆菌及铜绿假单胞菌在呼吸道标本中检出率最高(76.1%),其次是CVP导管尖端(8.7%),鲍曼不动杆菌对临床常用抗菌药物耐药率85%的有8种,对亚胺培南的耐药率也达70.3%,耐药率最低的仅有头孢哌酮/舒巴坦(17.1%);铜绿假单胞菌对替卡西林、亚胺培南有较高的耐药率,分别为45.2%、41.1%,对其他抗菌药物耐药率均25%。结论下呼吸道是ICU患者鲍曼不动杆菌和铜绿假单胞菌感染的主要部位;ICU患者感染以鲍曼不动杆菌和铜绿假单胞菌为主,鲍曼不动杆菌较铜绿假单胞菌耐药及多重耐药性严重。

Distribution and drug resistance of Acinetobacter baumannii and Pseudomonas aeruginosa in ICUs

Objective To explore the distribution and drug resistance of Acinetobacter baumannii（ABA） and Pseudomonas aeruginosa（PAE） in intensive care units（ICUs）.Method Clinical data of nosocomial infection with ABA and PAE isolates from July 2006 to June 2010 were investigated retrospectively.The results of susceptibility test against 111 ABA and 73 PAE strains were analyzed statistically.The antimicrobial susceptibility data was analyzed by WHONET 5.5 software.Result The ABA and PAE strains were mostly isolated from respiratory tract（76.1%）,followed by the CVP catheter tip（8.7%）.The resistant rates of ABA to eight testing drugs were more than 85%.The resistant rates to imipenem were 70.3%.Cefoperazone-Sulbactam was the only agent to which the bacteria showed the lowest resistance rate（17.1%）;The resistance rates of PAE to Ticarcillin and Imipenem were 45.2% and 41.1%.The resistant rates to other testing drugs were lower than 25%.Conclusion The lower respiratory tracts are the main infection site.Most of the pathogens in intensive care units are ABA and PAE.The resistant rate of ABA and MDR-AB are more serious than tjat pf PAE.