颅内感染鲍曼不动杆菌的耐药性及危险因素分析  

Drug Resistance and Risk Factors Analysis of Acinetobacter Baumannii in Intracranial Infection Isolated in Patients with Craniotomy

作　　者：任微[1] 李晓红[1,2] 褚美玲[1] 王璐[1] 薛文成[1] 杨婧[3] 

机构地区：[1]沈阳军区总医院检验科,辽宁沈阳110840 [2]辽宁医学院 [3]沈阳军区总医院感染控制科,辽宁沈阳110840

出　　处：《华南国防医学杂志》2016年第3期156-159,共4页Military Medical Journal of South China

基　　金：中华医院感染控制研究基金项目(2015-0035)

摘　　要：目的了解鲍曼不动杆菌(Acinetobacter baumannii,Aba)引起颅内感染耐药性特点及感染的危险因素,为指导临床合理选用抗菌药物及感染控制提供依据。方法回顾性分析2012-10/2015-10月作者医院神经外科颅内感染患者送检的脑脊液标本的临床及微生物资料,采用SPSS 19.0软件分析病原菌分布和Aba药敏结果以及Aba引起颅内感染的危险因素。结果在74株颅内感染的脑脊液标本中,分离到Aba 43株,其他病原菌31株,Aba占58.1%,该菌除对替加环素保持较高的敏感性外,对大多数抗菌药物的敏感性最高仅到20%。非多重耐药性Aba为5株(占11.6%),多重耐药Aba为16株(占37.2%),泛耐药Aba为22株(占51.2%)。患者发生肺炎、气管切开、气管插管、经外周静脉穿刺中心静脉置管术(peripherally inserted central catheter,PICC)置管及鼻饲是发生Aba颅内感染的危险因素。结论 Aba是引起颅脑手术患者颅内感染的最常见病原菌,且面临严峻的耐药形势,因此需要针对肺炎、气管切开、气管插管、PICC置管及鼻饲等危险因素制定有效的感染控制措施,减少Aba引起的颅内感染。Objective To analyze drug resistance and risk factors of Acinetobacter baumannii（Aba）in intracranial infection isolated from the patients with craniotomy,and provide the reference for clinical rational using of antibacterial agents and executing infection control measures.Methods The clinical data of 74 patients with intracranial infection in the authors＇ hospital during October 2012 to October 2015 were reviewed retrospectively.The pathogen distribution,resistance of Aba isolate and the risk factors caused intracranial infection were analyzed by SPSS19.0software.Results A total of 74 isolates were collected from the patients with craniotomy during 3 years.The most frequent pathogen isolated was Aba（58.1%）.There was high drug resistance in Aba isolates.Multivariate logistic regression analysis showed pneumonia,tracheotomy,tracheal intubation,peripherally inserted central catheter（PICC）catheterization,nasal feeding were the independent risk factors of Aba intracranial infection after craniotomy（P〈0.05）.Conclusion Resistant Aba is one most frequent pathogens in intracranial infection after craniotomy.Pneumonia,tracheotomy,tracheal intubation,PICC catheterization and nasal feeding are the independent risk factors of Aba intracranial infection.Relevant preventive measures should be strengthened to reduce the incidence of Aba intracranial infection.

关 键 词：颅内感染 鲍曼不动杆菌 耐药性 危险因素 

分 类 号：R378[医药卫生—病原生物学]