2007-2010年综合重症监护病房鲍氏不动杆菌的分布及耐药性分析  

Distribution and drug resistance of Acinetobacter baumanniiin comprehensive intensive care unit during 2007-2010

作　　者：蒋梅英[1] 章向成[2] 郑绍同[3] 嵇菊珍[1] 王菊芳[1] 李玉[1] 成玉春[1] 臧奎[2] 

机构地区：[1]南京医科大学附属淮安第一医院感管科,江苏淮安223300 [2]南京医科大学附属淮安第一医院综合重症监护病房,江苏淮安223300 [3]南京医科大学附属淮安第一医院检验科,江苏淮安223300

出　　处：《中华医院感染学杂志》2011年第20期4376-4378,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解综合重症监护病房(CICU)鲍氏不动杆菌(ABA)临床分布及耐药性,为指导临床用药,控制感染提供依据。方法回顾性调查2007-2010年医院CICU患者标本分离的96株ABA临床分布,并对其相关药敏试验结果进行统计分析,细菌分离采用常规鉴定方法及法国生物梅里埃公司的VITEK-32微生物自动鉴定仪鉴定。结果 4年中ABA检出率逐年上升,从2007年的4.55%升至2010年的9.76%,位次由2007年的第6位上升至2010年的第2位;96株ABA标本主要来源于呼吸道,占91.67%;多药耐药菌(MDRO)株检出率为82.29%;对头孢菌素耐药严重,对磷霉素、β-内酰胺类/β-内酰胺类酶抑制剂耐药率较低,对碳青霉烯类耐药率最低。结论 CICU中ABA检出率逐年增高,耐药严重,应加强对其监测与干预;临床应合理使用抗菌药物、加强手卫生、重点部位医院感染预防与控制、消毒灭菌及隔离工作对控制ABA感染至关重要。OBJECTIVE To investigate bacterial distribution and antibiotic resistance of Acinetobacter baumannii（ABA） nosocomial infections in comprehensive intensive care unit（CICU）,so as to provide evidence for guiding clinical practice.METHODS The clinical distribution and drug sensitivity test of 96 strains ABA isolated from patients in CICU collected from 2007 to 2010 were investigated and studied retrospectively.Bacterial were alalysed by routine method with VITEK-32 Automatic Microbe Analytic Systems.RESULTS The proportion of ABA has increased from 4.55% in 2007 to 9.76% in 2010,incidence rising from the sixth in 2007 to the second in 2010.96 ABA specimens were detected from respiratory tract,accounting for 91.67%,multiple drug-resistant strains accounted for 82.29%.ABA strains appeared most serious drug resistant to cephalosporins but lower resistant rate to fosfomycin,β-lactam/β-lactam inhibitor.The resistance rate to Carbapenems was minimum.CONCLUSIONS The detection rate of ABA strains in CICU is increasing year by year and it shows a high rate of drug resistance,which should attract more attention.Multi-disciplinary cooperation including infection management department,medical department,medicament department,moicrobiology lab is very important to control ABA nosocomial infections,and we should monitor the drug resistant strains,maintain hands wholesome,control,disinfect and isolate important infectious position,use antibiotics rationally.

关 键 词：鲍氏不动杆菌 感染 耐药性 对策 

分 类 号：R378[医药卫生—病原生物学]