摘要
目的分析医院感染患者多药耐药鲍氏不动杆菌(MDRAB)的临床特点和耐药性,对临床抗菌药物应用进行指导,有效治疗鲍氏不动杆菌造成的感染。方法收集2011年1月-2014年6月住院患者伤口分泌物或痰液标本中分离出的鲍氏不动杆菌110株,对MDRAB和非MDRAB的检测结果进行比较;采用SPSS18.0对研究结果进行统计分析。结果共分离出鲍氏不动杆菌110株,其中痰液与咽拭子标本所占比例最高,占90.91%,110株鲍氏不动杆菌中78株为MDRAB,MDRAB中有67株来自ICU患者,占60.90%;78株MDRAB除了对多黏菌素B、米诺环素、亚胺培南、头孢哌酮/舒巴坦以及美罗培南的耐药性<45.00%外,对于其他抗菌药物的耐药性均>90.00%;而32株非MDRAB对青霉素与β-内酰胺酶抑制剂复方抗菌药、米诺环素、阿米卡星以及第三代头孢菌素类抗菌药物未发现耐药性;MDRAB患者的用药种数和用药时间均明显高于非MDRAB患者,两者比较差异有统计学意义(P<0.05)。结论鲍氏不动杆菌的多药耐药性不断上升,应重点加强对ICU的抗菌药物耐药性监测,合理使用抗菌药物,减少耐药性菌株的流行并延缓多药耐药菌株产生。
OBJECTIVE To investigate the feature of multi-drug resistant Acinetobacter baumannii and its drug resistance so as to guide the clinical use of antibiotics and to treat infections.METHODS Totally 110 strains of A.baumannii were isolated from wound secretions and sputum samples from patients hospitalized from Jan.2011 to Jun.2014.The detection results of MDRAB and non-MDRAB were compared.All data were statistically analyzed by SPSS 18.0software.RESULTS A total of 110 strains of A.baumannii were isolated.And 90.01% of them were isolated from sputum and throat swab samples.Among them,78 were MDRAB,in which 67 were from patients in ICU,accounting for 60.90%.The 78 strains of MDRAB were less resistant to polymyxin B,minocycline,imipenem,cefoperazone/sulbactam and meropenem with the drug resistance rate lower than 45.00%.Except these antibiotics,they were resistant to other antibiotics with the rate over 90.00%.And 32 strains of non-MDRAB were not found to be resistant to penicillin,β-lactamase lactam enzyme inhibitor combination drugs,minocycline,amikacin and the third generation cephalosporins.and the number of drug use and medication time of patients with MDRAB were significantly higher than the non-MDRAB patients.The difference was significant（P〈0.05）.CONCLUSION A.baumannii has a rising trend in multi-drug resistance.Antibiotic drug resistance should be supervised intensively so that antibiotics can be used rationally to reduce the drug resistant strains and delay the production of multi-drug resistant strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第18期4096-4097,4118,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(Y2010C02)
关键词
医院感染
多药耐药鲍氏不动杆菌
临床特点
Hospital in{ection
Multiple drug resistant Acinetobacter baumannii
Clinical characteristics
