多药耐药鲍氏不动杆菌医院感染目标性调查及耐药性分析  

Targeted investigation of nosocomial infections caused by multidrug-resistant Acinetobacter baumannii and analysis of drug resistance

作　　者：杨春玲[1] 宋平 杨卉[1] 周传能 

机构地区：[1]烟台市烟台山医院医院感染管理科,山东烟台264008 [2]烟台市传染病医院医院感染管理科,山东烟台264001

出　　处：《中华医院感染学杂志》2013年第3期651-653,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解多药耐药鲍氏不动杆菌医院感染相关因素及其耐药性,以预防与控制多药耐药鲍氏不动杆菌医院感染的发生与流行。方法采用前瞻性和回顾性调查方法,对医院2008年1月22日-2010年12月28日多药耐药及全耐药鲍氏不动杆菌感染的63例患者进行综合性分析。结果多药耐药鲍氏不动杆菌感染患者中,36.5%为肺部感染合并多种基础性疾病,42.9%为多发性创伤骨折,73.0%入住过ICU,60.3%做过手术,38.1%～54.0%进行过各种侵入性操作,69.9%伴随混合菌感染;医院感染率为60.3%,总死亡率为31.7%,肺部感染死亡率高达71.4%;鲍氏不动杆菌耐药率高,其对头孢哌酮/舒巴坦的耐药率为15.9%,其次对亚胺培南的耐药率为31.7%,对其余抗菌药物耐药率达63.5%～100.0%。结论加强对多药耐药鲍氏不动杆菌医院感染全方位预防和控制,尤其是对ICU的监控已经刻不容缓。OBJECTIVE To investigate the relevant factors for nosocomial infections caused by multidrug-resistant Acinetobacter baumannii（MDRAB） and analyze its drug resistance so as to prevent and control the incidence and spreacl of MDRAB infections.METHODS By means of the prospective and retrospective survey,a total of 63 patients with multidrug-resistant A.baumannii and full drug-resistant A.baumannii infections,who enrolled the hospital form Jan 22,2008 to Dec 28,2010,were comprehensively analyzed.RESULTS Among the patients infected with multidrug-resistant A.baumannii,36.5% were with pulmonary infections complicated by multiple underlying diseases,42.9% were recurring traumatic fracture,73.0% have been hospitalized in ICU,60.3% have undergone the surgery,38.1%-54.0% undergoing various types of invasive operations,and 69.9% were complicated by mixed infections.The incidence rate of nosocomial infections was 60.3%,the overall mortality was 31.7%,and the fatality rate was 71.4% due to the pulmonary infections.The drug resistance rate of A.baumannii to cefoperazone/sulbactam was 15.9%,imipenem 31.7%,and the drug resistance rate to other antibiotics ranged between 63.5% and 100.0%.CONCLUSION It has been urgent to enhance the full range of prevention and control of nosocomial infections caused by multidrug-resistant A.baumannii,especially the monitoring of ICU.

关 键 词：多药耐药 鲍氏不动杆菌 综合性分析 预防 控制 

分 类 号：R978.1[医药卫生—药品]