综合性ICU住院患者下呼吸道鲍曼不动杆菌感染及耐药性监测  

Analysis on the infection of Acinetobacter baumannii and the drug resistance of patients with lower respiratory tract infection in comprehensive monitor ICU

作　　者：赵德军[1] 胡昭宇[1] 曹雁[1] 付维婵[2] 武静[1] 杨通钰[1] 胡鑫[1] 

机构地区：[1]解放军第44医院检验科,贵阳市550009 [2]解放军第44医院药剂科,贵阳市550009

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第2期87-89,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的调查ICU住院患者下呼吸道鲍曼不动杆菌感染现状及其对临床常用抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法通过法国梅里埃VITEK-2 Compact及ATB细菌鉴定分析仪对ICU住院患者送检的痰液标本进行病原菌鉴定,并用K-B法对分离病原菌进行体外药敏试验。结果 404份痰标本共分离出病原菌385株,其中鲍曼不动杆菌占25.2%。鲍曼不动杆菌对氨苄西林和头孢唑啉100.0%耐药,对哌拉西林、复方新诺明、环丙沙星、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢曲松和氨曲南等抗菌药物的耐药率均高于80.0%,对多黏菌素的耐药率最低。在分离的鲍曼不动杆菌中,多重耐药、泛耐药及全耐药菌株分别占91.7%、29.9%和2.1%。结论鲍曼不动杆菌对常用抗菌药物耐药性严重,临床应加强病原菌的分离培养,根据药敏试验结果合理用药。Objective To investigate the infection situation of Acinetobacter baumannii of inpatients with the lower respiratory tract infection in ICU, and to give some useful references in using antiviral medicines in clinical trial. Methods The pathogens of sputum specimens extracted from the ICU inpatients were identified by France VITEK-2 Compact ＆ ATB bacteria identification analyzer, and the vitro drug sensitivity test were taked for Acinetobacter baumannii separated by the K-B methodology. Results Total of 385 strains pathogens were isolated among the 404 sputum specimens, with Acinetobacter baumannii for 25.2%. The drug resistance rate of Acinetobacter baumannii to the ampicillin ＆ cafazolin were 100.0%, while to piperacillin, trimethoprim sulfamethoxazole, ciprofloxacin, ampicillin/sulbactam, piperacillin/tazabactam, eeftriaxone and aztreonam, etc. were all over 80.0%; and the lowest drug resistance rate was to the polymyxin. Among the isolated Acinetobacter baumannii, 91.7% were multiple-resistant strains, 29.9% were XDR strains, 2.1% strains were with the drug resistance rate for 100.0%. Conclusions The Acinetobacter baumannii is fairly resistant to commonly antiviral medicines, the isolating and cultivating for the pathogens in clinical trial should be strengthened. The rational use of the drug should according to the drug resistance results.

关 键 词：重症监护病房 下呼吸道感染 鲍曼不动杆菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]