摘要
目的研究23株分离自ICU病人的鲍曼不动杆菌的流行病学以及致病性,探索其间的关系。方法用K-B纸片法药敏试验测定抗菌药物敏感率;用脉冲场凝胶电泳分析同源性;用临床肺部感染评分(CPIS)评价致病情况。结果 23株鲍曼不动杆菌对常用13种抗菌药物的敏感率,阿米卡星的敏感率最高,为65.2%,其次米诺环素为52.2%,庆大霉素为21.7%,对哌拉西林、哌拉西林/他唑巴坦、舒巴坦/氨苄青霉素、亚胺培南和美罗培南敏感率均很低,为8.7%。同源性分析显示A基因型共10株,B基因型共3株,J基因型2株,其他基因型分别为C、D、E、F、G、H、I、K各一株。14例病人在培养出鲍曼不动杆菌前后肺部感染情况相对稳定,6例病人出现CPIS评分升高,3例在留取标本前CPIS评分为0分。结论 23株鲍曼不动杆菌对常用抗生素高度耐药;流行菌株随着时间不同存在一定的变化;虽培养出鲍曼不动杆菌生长,并非都引起严重的肺炎。
Objective To investigate the epidemiology and pathogenicity of 23 strains of acinetobacter baumannii isolated from intensive care unit（ICU） and explore the relationship between them.Methods K-B agar disk diffusion method was used to determinate antimicrobial sensitive rate.Homology of 23 strains of acinetobacter baumannii was analyzed by pulsed-field gel electrophoresis（PFGE）.The pathogenicity of acinetobacter baumannii was evaluated by clinical pulmonary infection score（CPIS）.Results Twenty-one of 23 strains were multi-drug resistant and also highly resistant to imipenem and meropenem.The most active agents were amikacin with susceptibility rate of 65.2%,followed by minocycline and gentamicin.The susceptibility rates of piperacillin,piperacillin/tazobactam,sulbactam/ampicillin,imipenem and meropenem were all 8.7%.Twenty-three strains were classified into mainly two types by PFGE.Ten strains belonged to type A.Three and two strains isolated from hematology department belonged to Type B,J.The other types,respectively C,D,E,F,G,H,I,K each one.The lung infection in 14 patients has not change and in 6 patients has increased after acinetobacter baumannii isolated from respiratory secretions.CPIS in 3 patients was zero.Conclusions Twenty-three acinetobacter baumannii strains were highly resistant to antibiotics.There are some changes of epidemic strains at different times.Although acinetobacter baumannii are isolated from respiratory secretions,some pathogens have not caused severe pneumonia.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2012年第6期422-424,共3页
The Chinese Journal of Clinical Pharmacology
关键词
鲍曼不动杆菌
致病性
临床肺部感染评分
acinetobacter baumannii
pathogenicity
clinical pulmonary infection score
