多重耐药鲍曼不动杆菌感染情况调查及耐药分析

目的 了解该院多重耐药鲍曼不动杆菌感染及耐药情况,并评价医院新管理措施的控制效果.方法 回顾性分析该院2009年11月至2011年10月期间384株鲍曼不动杆菌感染情况及耐药性特点,以及医院新管理措施实行前后的比较分析.结果 该院多重耐药鲍曼不动杆菌检出率为15.1%(58/384),其中有82.7%(48/58)分离自呼吸道标本,科室分布以重症监护室(ICU)最多,占44.8%(26/58),对美洛培南和亚胺培南的敏感性最高(93.1%和94.8%),其次是丁胺卡那霉素(46.6%),其余均低于10%.按年份分组比较分析显示该院执行新医院管理措施后多重耐药鲍曼不动杆菌的检出率由25.8%(56/217)降到1.2%(2/167),差异具有统计学意义(P<0.01);鲍曼不动杆菌对常见7种抗菌药物(头孢他啶、头孢吡肟、左氧氟沙星、环丙沙星、庆大霉素、丁胺卡那霉素和哌拉西林/他唑巴坦)敏感性显著提高(P<0.01).结论 医院新管理措施不但有效降低多重耐药鲍曼不动杆菌的感染率,还提高了鲍曼不动杆菌对抗菌药物的敏感性,值得进一步推广和加强.

Survey on multi-resistant Acinetobacter baumannii infection and analysis of drug susceptibility

Objective To investigate the infection of multi-resistant Acinetobacter baumannii and evaluate the efficiency of infection control program which performed in the hospital.Methods The survey was conducted over a period of 24months between Nov 2009and Oct 2011in the hospital.A total of 384of A.baumannii strains were isolated.The infection rates before and after the implementation of new infection control managements were compared.Results The detection rate of multi-resistant A.baumannii among all the isolated strains is 15.1% (58 /384).82.7% (48 /58) of them were isolated from respiratory tract specimens,while 44.8% (26 /58) were from intensive care unit (ICU).Isolates of A.baumannii were the most sensitive to meropenem and imipenem (93.1%and 94.8%,respectively),and amikacin for the next (46.6%).The sensitive rates of the isolates to the other antibiotics were lower than 10%.The infection rate of multi-resistant A.baumannii was decreased from 25.8% (56 /217) to 1.2% (2 /58) after the implementation of new infection control managements (P<0.01).Meanwhile,the sensitive rates of the A.baumannii isolates to seven regular antibiotics (ceftazidine,cefepime,levofloxacin,ciprofloxacin,gentamicin,amikacin,piperacillin /tazobactam) were significantly increased (P<0.01).Conclusion The infection control program in the hospital was effective not only in decreasing the infection rate of multi-resistant A.baumannii,but also in increasing the sensitive rates to the regular antibiotics.It is worthy to be applied widely.