恶性肿瘤患者医院感染鲍氏不动杆菌耐药性分析  

Antimicrobial resistance of Acinetobacter baumannii causing nosocomial infections in patients with malignant tumors

作　　者：范文[1,2] 黄娥[1,2] 雷鸿斌[1,2] 段六生[1,2] 

机构地区：[1]荆州市第一人民医院 [2]长江大学附属第一医院检验科,湖北荆州434000

出　　处：《中华医院感染学杂志》2014年第23期5743-5745,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(XF2008-23)

摘　　要：目的探讨恶性肿瘤患者鲍氏不动杆菌(ABA)医院感染的易感部位及其对抗菌药物的耐药性,为临床控制ABA感染提供正确用药的参考资料。方法调取医院2011年1月-2012年12月247例恶性肿瘤并发ABA医院感染患者的临床资料;感染性标本的采集运送、接种培养,ABA鉴定均严格依据临床微生物学检验的常规程序进行操作;药敏试验采用WHO指定的K-B法,数据采用WHONET 5.5软件进行处理,微生物检验实施全程室内质量控制。结果 247例患者ABA感染以下呼吸道感染率最高占55.0%,其次是泌尿系感染占15.4%、皮肤黏膜创面感染占14.2%;ABA对磺胺甲噁唑/甲氧苄啶耐药率最高,达到97.2%,ABA除对米诺环素、亚胺培南、美罗培南、头孢哌酮/舒巴坦的耐药性较低均<27.5%,对其他抗菌药物耐药率均>35.0%;247株ABA中泛耐药菌株检出率为21.1%;耐碳青霉烯类ABA检出率为27.5%。结论恶性肿瘤患者医院感染ABA的多药耐药和交叉耐药现象十分严重,医院务必提高肿瘤科医师的抗感染用药水平,力图控制细菌耐药性快速上升的危险倾向。OBJECTIVE To understand the vulnerable sites and drug‐resistance of nosocomial infection caused by Acinetobacter baumannii （ABA） in patients with malignant tumors and provide clinical reference for correct medi‐cation for ABA infection .METHODS The clinical records were investigated of 247 cases of ABA infection com‐bined with malignant tumors treated in the hospital during Jan .2011 to Dec .2012 .Infective specimens were col‐lected for bacterial culturation and identification by the microbiological rountine methods .The susceptibility testing was performed by the K‐B method recommended by WHO .The WHONET 5 .5 software was used to process the data .The internal quality control was performed throughout the test .RESULTS The rate of respiratory tract in‐fection was the highest ,accounting for 55 .0% among the 247 patients ,followed by urinary tract infection ac‐counting for 15 .4% ,and the wound infection of skin mucous membrane accounting for 14 .2% .Drug susceptibili‐ty test indicated that the resistance rate of ABA against sulfamethoxazole/trimethoprim was the highest ,up to 97 .2% .The resistances to minocycline ,imipenem ,meropenem ,cefoperazone/sulbactam were lower （〈27 .5% ） , but to other antibiotics were more than 35% .Of 247 ABA ,21 .1% and 27 .5% were pan‐resistant strains and car‐bapenems‐resistant strains ,respectively .CONCLUSION The multi‐resistance and cross‐resistance of ABA causing nosocomial infection in malignant tumor patients was serious ,indicating that the hospital should raise the level of clinical prescription to control the dangerous status of increasing bacterial resistance .

关 键 词：鲍氏不动杆菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]