ICU患者鲍氏不动杆菌导管相关性血流感染的耐药分析  

Drug resistance of Acinetobacter baumannii causing catheter-related bloodstream infections in ICU patients

作　　者：梁亮[1] 农生洲[1] 陈杏春[1] 林伟[1] 赵丽[1] 

机构地区：[1]广西壮族自治区人民医院检验科,广西南宁530021

出　　处：《中华医院感染学杂志》2013年第22期5545-5547,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区自然科学基金资助项目(桂科青0135017)

摘　　要：目的对ICU患者导管相关性血流感染的鲍氏不动杆菌对抗菌药物耐药性进行分析，以指导临床合理使用抗菌药物、降低细菌的耐药率。方法收集某院2008—2011年自ICU患者导管端培养及同时血培养阳性分离出的32株非重复鲍氏不动杆菌，用法国生物梅里埃公司VITEK-2分析仪对菌株进行测定及药敏试验，用Whonet5．5软件分析数据，按CLSI2011年版判读药敏结果。结果2008—2011年分离出的32株鲍氏不动杆菌对头孢他啶的耐药率为57．1％～72．7％，对亚胺培南的耐药率为20．O％～72．7％，对美罗培南的耐药率为20．0％～63．6％，对头孢哌酮／舒巴坦的耐药率为14．3％～22．2％；由于ICU常用的碳青霉烯类药物以亚胺培南最为常见，其中鲍氏不动杆菌对亚胺培南的耐药率相比，2008年与2011年差异有统计学意义（X2=3．883，P〈0．05）；其余各年份耐药率分别作两两比较，差异无统计学意义。结论ICU患者的导管相关性血流感染中，多药耐药鲍氏不动杆菌逐年增加，临床应根据药敏结果合理用药。OBJECTIVE To analyze the drug resistance of Acinetobacter baumannii causing catheter-related bloodstream infections in ICU patients so as to guide the clinical rational use of antibiotics and reduce the bacterial resistance. METHODS A total of 32 strains of non-repetitive A. baumannii cultured from catheter and patients with positive blood culture from 2008 to 2011 were collected, then VITEK-2 analyzer was used to identify the isolated strains, the drug susceptibility testing was carried out, and statistical analysis of the results was performed with Whonet5.5 software according to CLSI 2011. RESULTS The drug resistance rate of the 32 strains of A. baumannii to ceftazidime varied from 57.1% to 72.7%, imipenem from 20.0% to 72.7% ,meropenem from 20.0% to 63. 6%, and cefoperazone-sulbactam from 14. 3% to 22.2%, respectively; imipenem was the most commonly used carbapenems in the ICU, as compared with the drug resistance rate to imipenem between 2008 and 2011, the difference was statistically significant （chi-square ： 3. 883, P〈0.05）, and the difference in the drug resistance rate to other antibiotics was not statistically significant. CONCLUSION Among the ICU patients with catheter-related bloodstream infections, the detection rate of multidrug-resistant A. baurnannii increases year by year, antibiotics should be rationally used according to the result of drug susceptibility testing.

关 键 词：重症监护病房 导管相关性血流感染 鲍氏不动杆菌 

分 类 号：R378[医药卫生—病原生物学]