神经科ICU鲍氏不动杆菌医院获得性肺炎调查分析  

Investigation and analysis of acinetobacter baumannii lower respiratory tract nosocomial infections in neurological ICU

作　　者：刘克[1] 任丽丽[1] 樊明超[1] 张淑香[1] 刘婷[1] LIU Ke;REN Lili;FAN Mingchao;ZHANG Shuxiang;LIU Ting(Neurological ICU,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266003,China)

机构地区：[1]青岛大学附属医院神经科ICU,山东青岛266003

出　　处：《安徽医药》2019年第5期946-948,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的分析神经科ICU病人下呼吸道鲍氏不动杆菌(Acinetobacter baumannii,ABA)医院获得性感染病原菌分布及耐药性变化趋势,指导医院感染防控及临床抗感染治疗。方法回顾性分析青岛大学附属医院2008年1月至2015年12月共检出医院获得性肺部感染病原菌897株,统计分析ABA医院获得性下呼吸道感染分布及耐药性情况。结果 8年间总计117例病人分离培养下呼吸道ABA医院获得性肺炎菌株122株,占期间检出细菌株总数比例为9.21%。分离多耐药ABA菌株99株,占81.14%;泛耐药菌株11株,占9.02%。检出ABA对头孢哌酮/舒巴坦的敏感性较高,119株敏感,占97.54%。对亚胺培南、美罗和71.31%。结论神经科危重病人下呼吸道医院获得性肺部感染ABA耐药现象日趋严重。必须加强医院感染防控,合理使用抗菌药物,加强ABA耐药性监测。Objective To investigate the distribution and drug resistance of Acinetobacter baumannii(ABA)in the lower respiratory tract nosocomial infections in the Neurological ICU,and to provide scientific evidence for prevention and control of ABA infection.Methods A retrospective analysis on the antibiotic susceptibility test results of 897 strains of ABA isolated from lower respiratory tract nosocomial infection patients in the Affiliated Hospital of Qingdao University from Jan.2008 to Dec.2015 was conducted.ABA were isolated and identified referring to National Clinical Laboratory Procedures.And the bacteria identification and antibiotic susceptibility were performed by ATB expression and auxiliary kits were used.Results A total of 122 strains of ABA pathogens were isolated during the 8 years,accounting for 9.21%of all strains isolated from lower respiratory tract nosocomial infection patients in Neurosurgical ICU from Jan.2008 to Dec.2015.There were 91 multi-drug resistant strains(81.14%)and 8 pan-drug resistant strains had been isolated(9.02%).ABA was sensitive to Cefoperazone/Sulbactam,the rates of drug resistance was 7.54%.The drug resistance rates of Imipenem,Meropenem and Biapenem were 59.02%,59.84%and 71.31%.Conclusions The drug resistance of ABA in Neurosurgical ICU patients is severe.Cefoperazone/Sulbactam is the efficacious antibacterial for lower respiratory tract nosocomial infections of ABA in the Neurological ICU.It is important to control and carry out surveillance of bacterial drug resistance and rational use of antibiotics.

关 键 词：鲍氏不动杆菌 交叉感染 肺炎 重症监护 抗药性 细菌 头孢哌酮 亚胺培南 神经科重症加强护理病房 

分 类 号：R563.1[医药卫生—呼吸系统]