重症监护室鲍曼不动杆菌的感染情况及耐药性研究

目的了解重症监护室(ICU)鲍曼不动杆菌临床感染情况和耐药现状,以指导临床用药。方法回顾性分析2011年1～12月深圳市人民医院重症监护室分离的123株鲍曼不动杆菌的感染情况及耐药性。结果鲍曼不动杆菌最常出现在痰液标本中,占有58.53%,其次是引流液(17.89%)和血液(8.13%);其中多耐药鲍曼不动杆菌菌株共108株,占87.80%,导管、尿液、痰、引流液等培养的多耐药鲍曼不动杆菌的比例最高,分别为100%,100%,95.45%,90.82%;对替加环素耐药率最低,5.56%,其次为米诺环素及头孢哌酮/舒巴坦,分别为31.71%,42.27%,对其他抗菌药物的耐药率均大于65%,对亚胺培南及美罗培南的耐药率均大于85%。结论鲍曼不动杆菌是医院重症监护室感染中重要的条件致病菌,对抗菌药物耐药率高,且多重耐药,感染部位主要为呼吸道,替加环素、米诺环素及头孢哌酮/舒巴坦可作为治疗选择。

Infective and drug-resistant condition of acinetobacter baumannii (AB) in intensive care unit

Objective To search the infective and drug-resistant condition of acinetobacter baumannii(AB) in intensive care unit(ICU) for guiding the clinical usage of antibiotics.Methods Retrospectively analyzed locations and drug-resistant condition of 123 strains of AB in ICU of Shenzhen People’s Hospital from Jan,2011 to Dec,2011.Results AB was common cultured from sputum,which accounted for 58.53%.Drainage fluid(17.89%) and blood(8.13%) were followed.One hundred and eight strains of multiple drug-resistant AB(MDAB) were cultured,which accounted for 87.80%.MDAB was usually located in catheter(100%),urine(100%),sputum(95.4%) and drainage fluid(90.82%).Tiglycerin had a lowest resistant rate(5.56%),then Minocycline and Cefoperazone/sulbactam sodium were followed,which the resistant rates were 31.71% and 42.27% respectively.Resistant rates to other antibiotics were higher than 65%,and to Imipenem and Meropenem,the resistant rates were higher than 85%.Conclusions AB is the important conditional bacteria in ICU,which has high and multiple drug-resistant features.Airway is the common located and infected part.Tiglycelin,Minocycline,and Cefoperazone/sulbactam sodium should be rational choices.