鲍曼不动杆菌感染的危险因素及耐药性分析

目的 了解我院鲍曼不动杆菌的感染危险因素及耐药性.方法 经采用常规方法进行细菌培养、菌株鉴定及药敏检测.结果 158例患者共分离出238株鲍曼不动杆菌,患者主要集中在老年科(27.8％)、呼吸内科(26.6％)、神经内科(24.1％)、ICU( 16.5％),基础疾病以肺部疾病(77.8％)、神经系统疾病(51.9％)、心血管疾病(43.0％)、糖尿病(32.9％)多见,与有创检查或治疗(64.6％)、使用广谱抗生素(86.1％)可能存在相关性.对头孢哌酮/舒巴坦敏感性(66.4％)较高.对碳青霉烯类抗生素耐药性逐年上升,由20.4％上升至40.2％.结论鲍曼不动杆菌耐药情况严重,对碳青霉烯类耐药率逐年上升,可能与患者基础疾病、有创性检查或治疗、使用广谱抗生素有关.

Analysis of risk factors and drug resistance of Acinetobacter baumannii infection

Objective To investigate the risk factors of infection of Acinetobacter baumannii,and to analyze drug resistance of Acinetobacter baumannii strains.Methods The isolation of the bacterium was conducted according to the microorganical method of CLSI(Clinical and Laboratory Standards Institute).France BioMerieux ATB automatic analyzer was applied to species identification and drug susceptibility test.Drug resistance was calculated with WHONET5.4,and the results were analyzed with SPSS software.Results A total of 238 strains of Acinetobacter baumannii were isolated from 158 patients.The patients were mainly from geriatric department(27.8%),department of respiratory medicine(26.6%),department of neurology(24.1%),and intensive care unit(16.5%).Common underlying diseases were pulmonary diseases(77.8%),diseases of nervous system(52.9%),cardiovascular diseases(43.0%) and diabetes(32.9%).64.6% of the patients had accepted invasive operations before infection,and 86.1% were infused with broad-spectrum antibiotics,which indicated invasive operations and broad-spectrum antibiotics may be risk factors of infection of Acinetobacter baumannii.66.4% of the strains were susceptible to cefoperazone-sulbactam.The rate of resistance to carbapenem antibiotics was 40.2% in 2010,which was much higher than it in 2008(20.4%).Conclusion In conclusion,our data present that Acinetobacter baumannii show critical drug resistance.The rate of resistance to carbapenem antibiotics increases year by year.Underlying systemic diseases,invasive operations and broad-spectrum antibiotics may be risk factors of infection of Acinetobacter baumannii.