40株泛耐药鲍曼不动杆菌替加环素药敏分析

目的:总结培养的40株泛耐药鲍曼不动杆菌对替加环素的药敏情况。方法:22例住院患者一共分离出40株对目前临床常用药物不敏感的耐药鲍曼不动杆菌,分析菌株来源的病区、部位、患者的呼吸道情况和预后等。培养出来的鲍曼不动杆菌菌株采用K-B纸片扩散法进行药敏试验,选用15种抗菌药物和替加环素进行药敏试验。结果:25株菌株来自中心ICU(62.5%),8株来自急诊ICU(20%),5株来自呼吸ICU(12.5%),2株来自老干部病区(5%)。从取标本部位看,32株来自痰液(80%),来自腹腔引流液和伤口分泌物各2株(各5%),血流、深静脉导管、胸水、腹水各1株(2.5%)。这22例患者均有肺部感染(100%),有创机械通气20例(90.9%),需气管切开术12例(54.5%),死亡9例(40.9%)。药敏试验显示,对15种常用抗生素均不敏感,对头孢哌酮/舒巴坦和米诺环素的耐药率分别高达,82.5%、87.5%。对替加环素的耐药率为15%。结论:体外药敏试验显示鲍曼不动杆菌对头孢哌酮/舒巴坦和米诺环素的耐药性已相当严重,替加环素耐药率较低,可以作为泛耐药鲍曼不动杆菌感染治疗的首选药物。

40 strains of pan-drug resistant Bauman Acinetobacter tigecycline susceptibility analysis

Objective To summarize the cultured 40 strains of pan-drug resistant Acinetobacter Bauman of tigecycline susceptibility factors.Methods 22 patients with a total of 40 strains were isolated on Bauman is commonly used in clinical drug resistance is not sensitive to the Acinetobacter strains,analysis of the area,location,condition and prognosis of patients with respiratory tract.Trained Bauman Acinetobacter strains using K-B drug susceptibility tests were performed by using 15 kinds of antibacterial drugs,and tigecycline susceptibility test.Results 25 strains from the center for ICU(62.5%),8 strains were from the emergency ICU(20%),5 strains from respiratory ICU(12.5%),2 strains were from the old cadre ward(5%).From the specimen position,32 strains from sputum(80%),wound secretion from peritoneal fluid and 2 strains(5%),blood flow,deep venous catheter,hydrothorax,ascites in 1 strains(2.5%).Of the 22 patients had pulmonary infection(100%),20 cases of invasive mechanical ventilation(90.9%),12 patients(54.5%) required tracheotomy,9 cases of death(40.9%).The drug sensitivity test showed,are not sensitive to 15 antibiotics,resistance to Cefoperazone/Shubatan and minocycline rates were as high as,82.5%,87.5%.For tigecycline resistance rate was 15%.Conclusion Drug sensitivity test in vitro showed Bauman Acinetobacter resistance to Cefoperazone/Shubatan and minocycline has been very serious,tigecycline resistance rate is low,can be used as pan-drug resistant Bauman still the drug of choice for treatment of infection.