某院2011年重症监护病房鲍曼不动杆菌感染的耐药性分析

目的了解某院2011年重症监护病房(ICU)内鲍曼不动杆菌的耐药情况,为预防与治疗鲍曼不动杆菌感染提供依据。方法回顾性调查某院2011年ICU35例鲍曼不动杆菌感染病例的标本分布、耐药性、危险因素和抗菌药物使用情况。结果 ICU鲍曼不动杆菌主要来源于痰标本(35株,占85.37%),其次为创面分泌物(3株,占7.31%)。有基础疾病、侵入性操作、前期使用抗菌药物和激素、入住ICU、住院时间大于60d等是感染鲍曼不动杆菌的高危因素。鲍曼不动杆菌对头孢哌酮舒巴坦(100.0%)及亚胺培南西司他汀(92.5%)的敏感率较高,对其他16种抗菌药物的耐药率均在50.0%以上。临床治疗鲍曼不动杆菌感染多经验性选择第三代头孢菌素、喹诺酮及广谱青霉素类抗菌药物。结论 ICU内鲍曼不动杆菌耐药情况严重,控制感染的关键在于注意高危因素的防范,加强对该菌的耐药监测,合理使用抗菌药物。

Drug resistance analysis of Acinetobacter baumannii in a hospital intensive care unit in 2011

Objective To analysis the clinical distribution and resistance characteristics in isolates of Acinetobacter baumannii,and provide evidence for clinical prevention and therapy.Methods 41 A.baumannii strains were isolated from clinical specimens in intensive care unit of 35 cases in the hospital in 2011 for the investigation of drug resistance,risk factors and the use of antibacterial drugs.Results The majority of these Acinetobacter baumannii strains was isolated from sputum(35 strains,account for 85.37%) and wound exudates(3 strains account for 7.31%).Patients with common diseases,invasive operation,use of antibiotic drugs and hormones,and hospital stay greater than 60 days were prone to Acinetobacter baumannii infection.Cefperazone-Sulbactam was the most sensitive drug of treating Acinetobacter baumannii with the sensitivity of 100.0%,followed by imipenem 92.5%.Acinetobacter baumannii showed a resistance more than 50.0% for other 16 kinds of antibacterial drugs.Clinical treatment of Acinetobacter baumannii infection was mainly using third generation cephalosporin,quinolone and broad-spectrum of penicillin.Conclusion The infection of Acinetobacter baumannii in intensive care unit was in serious condition.It is important to reduce the unreasonable application of antibacterial drugs,pay attention to the prevention of risk factors,and strengthen the monitoring of drug resistance of bacteria.