ICU多药耐药鲍氏不动杆菌的耐药性分析  

Antimicrobial resistance of Acinetobacter baumanii in ICU

作　　者：郑颖[1] 陈亮[2] 鲁艳[3] 

机构地区：[1]襄阳市中心医院核医学科,湖北襄阳441021 [2]首都医科大学附属北京世纪坛医院验检中心,北京100038 [3]孝感市中心医院检验科,湖北孝感432000

出　　处：《中华医院感染学杂志》2014年第16期3918-3919,3938,共3页Chinese Journal of Nosocomiology

基　　金：湖北省科技厅自然科学基金资助项目(2012FFC120)

摘　　要：目的探讨综合医院ICU分离的多药耐药鲍氏不动杆菌(MDRAB)耐药性,为医师抗感染选择合适的抗菌药物提供参考依据。方法对2012年3所综合医院ICU分离的367株MDRAB耐药性进行了监测与统计分析;采用K-B法进行药敏检测,依据CLSI最新折点判断结果为敏感、中介、耐药,数据统计应用WHONET 5.5软件处理。结果 ICU分离的367株MDRAB在呼吸道标本中检出率最高,占67.6%;MDRAB耐药率>40.0%的药物包括磺胺甲噁唑/甲氧苄啶、阿米卡星、庆大霉素、头孢他啶、头孢噻肟、头孢吡肟、环丙沙星、左氧氟沙星和哌拉西林;耐药率<30.0%的抗菌药物有头孢哌酮/舒巴坦、哌拉西林/他唑巴坦。结论 ICU分离的MDRAB耐药性已非常严重,应加强执行卫生部发布的《抗菌药物临床应用管理办法》,将MDRAB纳入医院重点监控菌,实施医院多药耐药菌株预警制度,以警示临床医师,提高合理应用抗菌药物的责任感。OBJECTIVE To investigate antimicrobial resistance of 367multi-drug resistant Acinetobacter baumanii（MDRAB）in ICU of three general hospitals to provide the reference for clinical anti-infective treatment.METHODS Retrospective review was performed for antimicrobial resistance of 367 MDRAB isolates in three general hospitals in 2012.The susceptibility testing was performed by K-B methods.The testing results were read as sensitive,intermediary or resistant according to the newest breakpoints of CLSI.The WHONET 5.5software was used to process the data.RESULTS The detection rate of MDRAB from respiratory tract was the highest,accounting for 67.6%.The susceptibility results showed antibiotics with more than 40% of resistant rate included sulfamethoxazole/trimethoprim,amikacin,gentamicin,cefazolin,cefotaxime,cefepime,ciprofloxacin,levofloxacin and piperacillin.Those with less than 30% of resistant rate were cefoperazone/sulbatan,piperacillin/tazobactan.CONCLUSION Resistance of MDRAB from ICU was very severe.Hospitals should strengthen implementation of Clinical Application Management of Antibiotics issued by Ministry of Public Health and monitoring of resistant MDRAB and develop warning mechanism of bacterial resistance to alert the clinician to improve the responsibility of reasonable application of antibiotics.

关 键 词：重症监护病房 鲍氏不动杆菌 多药耐药性 耐药性 

分 类 号：R378[医药卫生—病原生物学]