重症监护病房与非重症监护病房鲍曼不动杆菌分布和耐药性比较

目的：比较ICU与非ICU鲍曼不动杆菌分布和耐药性。方法回顾性对比分析ICU分离出的1079株和非ICU分离出的8413株细菌；细菌鉴定和药敏试验采用VITEK 2 Compact全自动细菌培养鉴定仪。结果 ICU分离鲍曼不动杆菌最多，构成比（29．2％）明显高于非ICU（6．2％）（χ2＝625．955，P＜0．05）；ICU耐亚胺培南鲍曼不动杆菌（IRAB）的检出率（91．7％）明显高于非ICU（43．5％）（χ2＝193．541，P＜0．05）；ICU和非ICU分离细菌的标本均主要来源于痰液，构成比分别为64．0％和32．9％。 ICU和非ICU分离的鲍曼不动杆菌对阿米卡星耐药率较低（20．0％～21．6％），ICU分离的鲍曼不动杆菌对三、四代头孢菌素、酶抑制剂复合药物、碳青霉烯类、喹诺酮类等广谱抗菌药物的耐药率明显高于非 ICU （χ2＝146．124、104．409、253.171、195．646、186．580，均P＜0．05）。结论多重耐药鲍曼不动杆菌在ICU的检出率高，应加强细菌监测，合理用药，降低细菌的耐药性。

Comparison of specimens of ICU and the ICU Acinetobacter baumannii distribution and drug resistance analysis

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit（ICU） and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form （29.2%） was significantly higher than the ICU （6.2%）,the difference was statistically significant （χ2 =625.955, P〈0.05）.ICU imine resistant Acinetobacter baumannii from south （IRAB）detection rate（91.7%）was significantly higher（43.5%） than the ICU,difference was statistically significant （χ2 =193.541,P〈0.05）;Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low （20.0%-21.6%）,the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant（χ2 =146.124,104.407,253.171,195.646,186.580,all P〈0.05）.Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .