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神经重症监护病房多药耐药鲍氏不动杆菌医院感染临床对策
引用本文:董国英,王志宏,李连弟,王景峰,单亮,戴彩云.神经重症监护病房多药耐药鲍氏不动杆菌医院感染临床对策[J].中华医院感染学杂志,2009,19(21).
作者姓名:董国英  王志宏  李连弟  王景峰  单亮  戴彩云
作者单位:1. 青岛大学医学院附属医院医务处,山东,青岛,266003
2. 青岛大学医学院附属医院神经ICU,山东,青岛,266003
摘    要:目的 通过对神经重症监护病房(NICU)多药耐药鲍氏不动杆菌医院感染处理方法的分析,为医院感染发生后的临床对策提供依据.方法 对6例发生多药耐药鲍氏不动杆菌感染患者综合应用隔离,增强患者抵抗力、缩窄抗菌谱、选留针对性的敏感抗菌药物等措施,控制多药耐药鲍氏不动杆菌医院感染.结果 多药耐药鲍氏不动杆菌所致医院感染均有较严重的基础疾病,发病前曾使用一种或多种抗菌药物,药敏结果显示,其对亚胺堵南、含酶抑制剂的β-内酰胺类抗菌药物的耐药性较低;5例痰培养多药耐药鲍氏不动杆菌转阴,1例医院获得性肺炎明显好转.结论 综合应用隔离、增强患者抵抗力以及缩窄抗菌谱,选留针对性敏感抗菌药物等措施,可以控制NICU多药耐药鲍氏不动杆菌感染.

关 键 词:多药耐药鲍氏不动杆菌  医院感染  临床对策  神经重症监护病房

Nosocomial Infections in Neurological Intensive Care Unit
DONG Guo-ying,WANG Zhi-hong,LI Lian-di,WANG Jing-feng,SHAN Liang,DAI Cai-yun.Nosocomial Infections in Neurological Intensive Care Unit[J].Chinese Journal of Nosocomiology,2009,19(21).
Authors:DONG Guo-ying  WANG Zhi-hong  LI Lian-di  WANG Jing-feng  SHAN Liang  DAI Cai-yun
Abstract:OBJECTIVE By analyzing the treatment measures of multi-drug resistant Acinetobacter baumannii nosocomial infections in NICU, the authors provide the reference for disposal of the analogy of the nosocomial infections. METHODS Ten cases suffering multidrug resistant A. baumannii nosocomial infeltions were treated with isolation and promoted patients immunology, combined with sensitive antimicrobial therapy,avoiding applying antibiotic broad-spectrum therapy plan for a long time to control the nosocomial infections of multi-drug resistant A. baumannii. RESULTS All of the patients sufered from severe basic diseases. At least one kind of antibiotics was used in all cases. The results of bacterial susceptibility showed that acinetobacter had multiple drug resistance,but was less resistant to Imipenem and β-lactams with the component of enzyme depression. Bacterial culture became negative in nine cases, and hospital aquarot pneumonia became better. CONCLUSIONS The treatment of isolation and promoted patients resistance, combined with sensitive antimicrobial therapy, avoiding applying antibiotic broad-spectrum for a long time may control multi-drug resistant A. baumannii infection in NICU.
Keywords:Multi-drug resistant Acinetobacter baumanii  Nosocomial infection  Clinical treatment  Neurological intensive care unit
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