医院ICU洋葱伯克霍尔德菌感染分布及耐药性分析  

Distribution of Burkholderia cepaciainfections in ICUs and drug resistance

作　　者：杨兵[1] 马海丽 寿雨薇 张雪灵[1] 秦超 

机构地区：[1]郑州铁路职业技术学院护理学院,河南郑州450052

出　　处：《中华医院感染学杂志》2017年第21期4822-4825,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析ICU洋葱伯克霍尔德菌医院感染情况及耐药特点。方法选择2012年1月-2016年12月医院ICU洋葱伯克霍尔德菌感染患者318例为研究对象,分析不同年份洋葱伯克霍尔德菌感染率、标本来源及对常用抗菌药物的耐药率。结果 2012年-2016年入住ICU患者共6339例,其中318例发生洋葱伯克霍尔德菌感染,感染率为5.0%;近5年洋葱伯克霍尔德菌感染呈上升趋势,2016年感染率为7.0%,显著高于2012-2015年的3.3%,3.7%,4.3%,4.5%,差异有统计学意义(P<0.05);2012年-2016年ICU洋葱伯克霍尔德菌主要以痰液分离为主,占59.12%,显著高于血、腹水、尿、分泌物、脓液等其他标本,差异有统计学意义(P<0.05);2012年-2016年ICU洋葱伯克霍尔德菌感染患者原发病以呼吸系统疾病为主,占33.02%,显著高于恶性肿瘤及其他原发病,差异有统计学意义(P<0.05);药物敏感试验显示近年来洋葱伯克霍尔德菌耐药菌株逐渐增加,耐药率有上升的趋势,其中2016年其对阿米卡星、庆大霉素、氨苄西林、头孢曲松、头孢替坦、呋喃妥因的耐药率均>90%,对磺胺甲噁唑/甲氧芐啶的耐药率最低。结论重症监护室洋葱伯克霍尔德菌感染率逐年上升,耐药株也有上升的趋势,临床上应选择敏感药物及时给予治疗。OBJECTIVE To investigate the prevalence of Burkholderia cepacia infections in ICUs and analyze the characteristics of drug resistance.METHODS A total of 318 patients with B.cepaciainfections who were treated in ICUs from Jan 2012 to Dec 2016 were recruited as the study objects.The incidence of B.cepaciainfections in different years,specimens sources and drug resistance rates to commonly used antibiotics were observed.RESULTS Of totally 6339 patients who were hospitalized the ICUs from 2012 to 2016,318 had B.cepaciainfections,with the infection rate 5.0%.The prevalence rate of B.cepaciainfections showed an upward trend in the recent five years,the infection rate was 7.0% in 2016,significantly higher than 3.3% in 2012,3.7% in 2013,4.3% in2014,4.5%in 2015（P〈0.05）.Among the B.cepaciastrains that were isolated from the specimens sources in the ICU from 2012 to 2016,59.12% were isolated from sputum specimens,significantly higher than the blood,ascites,urine,secretions and pus specimens（P〈0.05）.Among the B.cepaciainfection patients with primary diseases who were treated in the ICUs from 2012 to 2016,33.02% had respiratory system diseases,significantly higher than the patients with malignant tumors and other primary diseases（P〈0.05）.The result of drug susceptibility testing showed that the drug-resistant B.cepaciastrains were increased in recent years,the drug resistance rates showed upward trend,the drug resistance rates to amikacin,gentamicin,ampicillin,ceftriaxone,cefotetan and nitrofurantoin were more than 90% in 2016,and the drug resistance rate to sulfamethoxazole-trimethoprim was the lowest.CONCLUSION The incidence of B.cepaciainfection is increased year by year in the ICUs,the drug-resistant strains show upward trend,and it is necessary for the hospital to choose sensitive antibiotics for timely treatment.

关 键 词：洋葱伯克霍尔德菌 重症监护室 医院感染 耐药 

分 类 号：R378[医药卫生—病原生物学]