ICU鲍氏不动杆菌医院感染耐药性分析  

Drug resistance of Acinetobacter baumannii causing nosocomial infections in ICU

作　　者：袁咏梅[1] 许波银[1] 姜燕南[1] 张燕萍[1] 

机构地区：[1]南通大学附属医院医院感染管理科,江苏南通226001

出　　处：《中华医院感染学杂志》2013年第13期3249-3251,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨ICU鲍氏不动杆菌(ABA)医院感染的分布特征及耐药性,为指导临床合理选用抗菌药物提供依据。方法对2010年1-12月ICU分离出的87株医院感染鲍氏不动杆菌分布及耐药性进行统计分析。结果鲍氏不动杆菌在ICU的检出率较高,其中90.80%的标本来源于下呼吸道;该菌多药耐药现象严重,87株鲍氏不动杆菌耐药率最低的是多黏菌素为5.75%,对亚胺培南和美罗培南的耐药率达75.86%,对头孢三代、头孢四代、阿米卡星耐药率分别为87.36%、83.91%、80.46%,对哌拉西林/他唑巴坦、庆大霉素、替卡西林/克拉维酸、环丙沙星耐药率均>90.0%;泛耐药鲍氏不动杆菌(PDRAB)检出17株,占19.54%。结论 ICU医院感染鲍氏不动杆菌耐药严重,医院应加强对ABA耐药性的监测,实施有效的预防控制措施,尽量减少和延缓耐药株和泛耐药株的产生,防止多药耐药ABA医院感染暴发流行。OBJECTIVE To investigate the characteristics of distribution of nosocomial infections and drug resistance of Acinetobacter baumannii（ABA）in the intensive care unit so as to provide clinical guidance for reasonable application of antibiotics.METHODS The distributions and drug resistance of 87strains of ABA isolated from patients in ICU who suffered from nosocomial infections from Jan 2010to Dec 2010were statistically analyzed.RESULTS The data showed that the A.baumannii had a higher detection rate in the ICU.Among all the specimens,about 90.80% were isolated from the lower respiratory tract.A.baumannii was highly multidrugresistant;of 87strains of ABA,the drug resistance rate to the polymyxin was 5.75%,imipenem and meropenem 75.86%,the third generation of cephalosporins 87.36%,the fourth generation cephalosporins 83.91%,and amikacin 80.46%,while the drug resistance rates to piperacillin-tazobactam,gentamicin,ticarcillin-clavulanic acid,and ciprofloxacin were higher than 90.0%.There were 17（19.54%）strains of pan-drug resistant A.baumannii（PDR-AB）isolated.CONCLUSION The drug resistance of the A.baumannii strains causing nosocomial infections in ICU is serious,the hospital should strengthen the monitoring of drug resistance of the ABA,carry out the effective prevention and control measures,minimize and delay the emergence of the resistant strains so as to prevent the outbreak of nosocomial infections caused by multidrug-resistant ABA.

关 键 词：医院感染 鲍氏不动杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]