25例鲍氏不动杆菌血流感染临床分析  

Clinical analysis of Acinetobacter baumanniiblood stream infections in 25 patients

作　　者：陈柱[1] 张丽[1] 李媛媛[2] 韩娜[1] 张民伟[1] 

机构地区：[1]厦门大学附属第一医院重症医学科,福建厦门361003 [2]宁德市医院麻醉科,福建宁德352000

出　　处：《中华医院感染学杂志》2013年第5期1163-1165,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨鲍氏不动杆菌血流感染的临床学及细菌学特点,为临床治疗鲍氏不动杆菌血流感染提供指导。方法对医院2010年1月-2011年12月25例鲍氏不动杆菌血流感染患者的临床资料及细菌学资料进行统计分析。结果 25例鲍氏不动杆菌血流感染患者主要来自ICU、呼吸科,两者占72.0%;平均年龄63岁;21例患者住院>2周,占84.0%,住院>1个月12例,占48.0%;存在侵入性操作占72.0%,死亡率28.0%;药敏结果显示,替加环素敏感性最高,达100.0%,其次是阿米卡星,敏感性>90.0%,其他抗菌药物敏感率均<40.0%;14例泛耐药,占56.0%;泛耐药与非泛耐药菌株比较,血培养阳性前两周内使用碳青霉烯类抗菌药物及侵入性操作差异有统计学意义(P<0.05)。结论鲍氏不动杆菌血流感染出现泛耐药菌株比例高,患者病死率高;高龄、侵入性操作、住院时间>2周是常见易感因素,使用碳青霉烯类抗菌药物及侵入性操作可能是发生泛耐药病例的高危因素。OBJECTIVE To study the clinical and bacteriological characteristics of bloodstream infections caused by Acinetobacter baumannii so as to guide the clinical treatment of the bloodstream infections.METHODS The clinical and bacteriological characteristics of 25 patients with bloodstream infections caused by A.baumannii in the hospital from Jan 2010 to Dec 2011 were statistically analyzed.RESULTS Totally 25 patients with the bloodstream infections mainly distributed in ICU and the respiratory department,accounting for 72.0%.The average age was 63 years old.There were 21（84.0%） cases of patients with the length of hospital stay more than 2 weeks and 12（48.0%） cases of patients with the length of hospital stay more than one month.The patients who underwent the invasive operation accounted for 72.0%,the mortality was 28.0%.The antimicrobial susceptibility testing result showed that the drug susceptibility rate to tigecycline was the highest（100.0%）,amikacin more than 90.0%,and other antibiotics less than 40.0%.There were totally 14（56.0%） strains of pandrug-resistant isolates.As compared with the pandrug-resistant strains and non-pandrug-resistant strains,the differences in the use of carbapenems antibiotics two weeks before the blood cultured positive and the invasive operation were statistically significant（P0.05）.CONCLUSION The pandrug-resistant strains take a large proportion of the A.baumannii isolates causing bloodstream infections,the mortality of the patients is high.The old age,invasive operation,and more than 2 weeks of hospital stay are the common predisposing factors.The use of carbapenems antibiotics and invasive operation may be high-risk factors for the pan-drug resistant cases.

关 键 词：鲍氏不动杆菌 血流感染 耐药 

分 类 号：R378[医药卫生—病原生物学]