鲍曼不动杆菌在重症医学科中的感染分布和耐药谱分析  

Infection distribution and drug resistance spectrum of Acinetobacter bauman in the intensive care unit

作　　者：李荣琴[1] 方琪[1] 陶炫霖 李佳星[1] 

机构地区：[1]重庆市綦江区人民医院感染管理科,401420

出　　处：《检验医学与临床》2016年第17期2423-2425,共3页Laboratory Medicine and Clinic

基　　金：重庆市卫生和计划生育委员会项目(2013-2-245);綦江区科委科技计划项目(2014.052;2014.048)

摘　　要：目的了解重症监护室(ICU)鲍曼不动杆菌的分布和耐药谱,以期为临床合理使用抗菌药物提供参考。方法收集2013年2月至2015年8月从该院ICU住院患者感染性标本中分离出的鲍曼不动杆菌118株,分析其感染分布情况,并按美国临床实验室标准化委员会(NCCLS)推荐方法对产超广谱β-内酰胺酶(ESBLs)菌株进行初筛和确认,以K-B琼脂扩散法进行药物耐药谱的分析。结果 ICU鲍曼不动杆菌菌株主要来自痰液[71.19%(84/118)]、咽拭子[12.71%(15/118)]和尿液[10.17%(12/118)]等。分离临床标本来源于呼吸系统疾病的占57.63%(68/118),消化系统疾病占16.95%(20/118),血液系统疾病占11.86%(14/118)。产ESBLs鲍曼不动杆菌检出率为47.46%(56/118),以痰液为主[73.21%(41/56)],而且产ESBLs鲍曼不动杆菌株对各类抗菌药物的耐药率明显高于非产ESBLs菌株(P<0.05)。结论 ICU产ESBLs鲍曼不动杆菌的耐药情况较严重,应及时监控产ESBLs菌的感染分布及其耐药性。Objective To explore the infection distribution and drug resistance of Acinetobacter bauman in the intensive care umt （ICU） ,and provid scientific basis for clinical rational use of antibiotics. Methods 118 strains of Acinetobacter bauman were isolated from hospitalized IGU patients in the hospital from February 2013 to August 2015. The infection distribution was analyzed,screening and confirmation of extended spectrum β-lactamases（ESBLs）-producing strains was conducted according to the NCCLS recommended method,and the drug resistant spectrum analysis was performed by using K-B agar diffusion. Results Acinetobaeter bau- man in ICU mainly came from sputum[71.19% （84/118）] ,throat swabs[12.71% （15/118）] and urine[10.17% （12/118）], which were isolated from the patients suffering from respiratory diseases [ （ 57. 63 % （68/118） ], digestive system diseases [ 16. 95 % （ 20/ 118）] and blood diseases[11. 86% （14/118）]. The detection rate of ESBLs-producing Acinetobacter bauman was 47.46 % （56/118） and mainly came from sputum[73.21% （41/56）]. Drug resistance of ESBLs-producing Acinetobacter bauman strains against various types of antibiotics was significantly higher than the non-ESBLs-producing strains（P〈0.05）. Conclusion The resistance of ESBLs-producing Aeinetobacter bauman in ICU is serious and the infection distribution and drug resistance of ESBLs-producing bacteria should be monitored in time.

关 键 词：鲍曼不动杆菌 分布 耐药谱 产超广谱Β-内酰胺酶 重症医学科 

分 类 号：R378[医药卫生—病原生物学]