老年患者耐亚胺培南鲍氏不动杆菌医院感染调查及耐药性分析  

Imipenem-resistant acinetobacter baumannii causing nosocomial infection in elderly patients and drug resistance

作　　者：邵剑飞[1] 佘军[1] 王天翔[1] 顾保罗[1] 

机构地区：[1]杭州萧山第一人民医院检验科,浙江杭州311201

出　　处：《中华医院感染学杂志》2011年第8期1680-1682,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院耐亚胺培南鲍氏不动杆菌（IRAB）的医院感染情况及耐药特点。方法对医院2009年1-12月64例IRAB医院感染患者进行回顾性分析感染危险因素和药物敏感试验。结果 64例患者感染部位以呼吸道为主,占73.44%;病区主要分布在ICU和呼吸内科,分别占53.13%和12.50%;感染前使用三代头孢菌素和碳青霉烯类、广谱抗菌药物应用和侵入性操作治疗时间过长、住院时间尤其是入住ICU时间过长是IRAB医院感染的相关危险因素;IRAB对常规抗菌药物均高度耐药,耐药率在89.00%~100.00%,仅对头孢哌酮/舒巴坦、多黏菌素表现高敏感性。结论 IRAB是老年患者引起医院感染的重要致病菌之一,其高耐药性导致临床治疗困难,须加强药物的合理使用,正确的经验用药,同时应严格采取消毒隔离措施,防止IRAB的定植和传播。OBJECTIVE To study the imipenem-resistant Acinetobacter baumannii（IRAB） hospital infection and drug resistance.METHODS From Jan to Dec 2009,a total of 64 cases IRAB the retrospective analysis of patients with nosocomial infection risk factors for infection and drug susceptibility test.RESULTS Totally 64 cases of patients were with respiratory tract infection（accounting for 73.44%）;most of them isolated from ICU ward and respiratory medicine,accounting for 53.13% and 12.50%;infection before the use of third generation cephalosporins and carbapenems,broad-spectrum antibiotic therapy and invasive operation,hospital stay too long,especially prolonged ICU stay is IRAB related risk factors for nosocomial infection;IRAB were highly resistant to conventional antibiotics with resistant rate of 89.00%-100.00%,only to cefoperazone/sulbactam,polymyxin showed high sensitivity.CONCLUSION IRAB is one of the major pathogens causing nosocomial infection,and its high resistance leads to clinical problems.Rational use of medicines,right experience,medication,taking strict disinfection and isolation measures should be performed to prevent the colonization and dissemination of IRAB.

关 键 词：耐亚胺培南鲍氏不动杆菌 医院感染 耐药性 危险因素 

分 类 号：R378[医药卫生—病原生物学]