摘要
目的分析ICU鲍氏不动杆菌医院感染的分布及耐药性,指导临床医师合理选择抗菌药物进行治疗和预防,以控制医院感染发生。方法采用氧化酶法、糖类发酵试验等对鲍氏不动杆菌进行初筛,并利用微生物全自动分析仪进行细菌鉴定及纸片扩散法进行药敏测定,并对ICU鲍氏不动杆菌分布和耐药性进行统计分析。结果2009年1月-2012年2月ICU共分离出鲍氏不动杆菌344株,占全院27.02%;标本主要来源于痰液,为306株,占88.95%;鲍氏不动杆菌对头孢菌素类、氨基糖苷类和青霉素类的耐药率均>60.00%,对哌拉西林/他唑巴坦的耐药率也高达70.64%,对头孢哌酮/舒巴坦和米诺环素的耐药率较低,分别为0.87%和20.06%,对亚胺培南的耐药率呈逐年增高趋势。结论 ICU鲍氏不动杆菌对抗菌药物的耐药现状严重,多药耐药株检出率逐渐增加;临床医师应根据病情及时做病原菌检测,结合药敏试验结果合理使用抗菌药物,同时应加强鲍氏不动杆菌的控制与监测。
OBJECTIVE To investigate the distribution and drug resistance of Acinetobacter baumannii causing nosocomial infections in ICU,so as to guide the clinical reasonable selection of antibiotics for the prevention and treatment and control the nosocomial infections.METHODS By means of the oxidase method,sugar fermentation testing was performed to screen A.baumannii early,and bacterial identification was performed by microorganism automatic analyzer,and the antibiotics susceptibility was performed by the disc diffusion method.The distribution and drug resistance of A.baumannii in ICU were statistically analyzed.RESULTS A total of 344（27.02%） A.baumannii strains were isolated from ICU from Jan 2009 to Feb 2012,most of the isolates were from the sputum specimens,accounting for 88.95%.The antibiotics susceptibility testing result showed that the drug resistance rates of A.baumannii to cephalosporins,aminoglycosides and penicillins were higher than 60.00%,the drug resistance rate to piperacillin/sulbactam was as high as reaching up to 70.64%,the drug resistance rates to cefoperazone/sulbactam and minocycline were relatively low,which were 0.87% and 20.06%,respectively,and the drug resistance rate to imipenem increased year by year.CONCLUSION The drug resistance of the A.baumannii isolated from the ICU is so serious,the isolation rate of the multidrug-resistant strains keeps an upward tendency.The clinicians should perform the pathogen detection in a timely manner and use antibiotics on the basis of drug susceptibility testing,strengthening the control and monitoring of A.baumannii.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第5期1160-1162,共3页
Chinese Journal of Nosocomiology
关键词
鲍氏不动杆菌
耐药性
医院感染
Acinetobacter baumannii
Drug resistance
Nosocomial infection
