224例鲍曼不动杆菌感染的临床特征及耐药性分析  

Analysis of clinical characteristics and drug resistance of 224 strains of Acinetobacter baumannii infection

作　　者：徐薛芬[1] 徐爱晖[1] 

机构地区：[1]安徽医科大学第一附属医院呼吸内科,安徽合肥230022

出　　处：《临床肺科杂志》2013年第3期461-463,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的了解我院224例鲍曼不动杆菌感染的临床特征及耐药性。方法采用常规方法进行细菌培养、菌株鉴定及药敏检测。结果 201名患者共分离出224株鲍曼不动杆菌,患者主要集中在ICU(33.8%)、外科(25.9%)、呼吸内科(14.4%)、骨科(6.1%),基础疾病以呼吸系统疾病(64.2%)、心血管系统疾病(30.8%)、神经系统疾病(29.8%)及糖尿病(22.9%)多见,与手术治疗及有创检查治疗(56.7%)、联合使用≥2种抗生素(80.6%)及使用时间≥15天(38.8%)可能存在相关性。224株鲍曼不动杆菌对米诺环素敏感性最高(66.1%),对美罗培南、氨苄西林/舒巴坦、头孢哌酮/舒巴坦敏感性超过55%。结论鲍曼不动杆菌感染与患者有基础疾病、有创性检查治疗及使用广谱抗生素及时间过长有关,其耐药情况严重,多重耐药及泛耐药菌株日益增多,目前对米诺环素、舒巴坦、碳青酶烯类抗生素仍保持相对敏感性,临床应根据药敏结果合理选择使用抗生素。Objective To investigate the clinical charateristics of infection of 224 Acinetobacter baumannii strains, and to analyze drug resistance of Aeinetobacter baumannii strains. Methods The isolation of the bacterium was conducted according to the microorganical method of CLSI （ Clinical and Laboratory Standards Institute）. American DATE Company MicroScan Walkway-40 automatic analyzer was ap- plied to identification and drug susceptibility test. Drug resistance was calculated with WHONET5.4 software. Results A total of 224 strains of Acinetobacter banmannii were isolated from 201 patients. The patients were mainly from ICU（ intensive care uint） （33.8%）, de- partment of surgery （25.9%）, department of respiratory medicine （ 14.4% ）, department of orthopedics （6. 1% ）. Common underlying diseases were pulmonary diseases （64. 2% ） , cardiovascular diseases （30. 8% ）, diseases of nervous system （29.8%） and diabetes （22. 9% ）. 56.7% of the patients had accepted invasive inspections or operations before infection, 80.6% were infused with a combination of two or more kinds of antibiotics and 38.8% were received more than 15 days antimicrobial therapy, which indicated invasive inspections or operations and inappropriate antibiotic therapy may be risk factors of infection of Acinetobacter baumannii. 66. 1% of the 224 strains were susceptible to minocycline. The rates of susceptihility to meropenem,ampicilin-sulbactam,cefopcrazone-sulhactam were more than 55%. Conclusion In conclusion, our data present that underlying systemic diseases, invazive inspections or operations and inappropriate antibiot- ic therapy may be risk factors of infection of Acinctobacter baumannii. The drug resistance of Acinetobacter hanmannii was critical, MDR （multi-drug resistance） and FDR（pan-drug resistance） Aeinetobaeter baumannii are increasing. It still remain sensitive to minocycline, sulbactam, carbapenems at present. Antibiotics should be rationally used in clinical application according to the resul

关 键 词：鲍曼不动杆菌 感染临床特征 耐药性 

分 类 号：R446.5[医药卫生—诊断学]