重症监护病房不动杆菌感染的流行和耐药性分析

Study on the nosocomial outbreak and the antimicrobial resistance of Acinetobacter spp.isolated from patients in ICU

目的了解浙江省人民医院重症监护病房(ICU)不动杆菌暴发流行原因和耐药性,预防医院感染的发生。方法回顾性分析该院ICU 2004年临床标本中分离的不动杆菌。结果该院ICU 2004年不动杆菌感染在所有的分离菌株中所占比例最高,达26.7%;不动杆菌感染主要源于呼吸道样本,占79.1%;该院不动杆菌的耐药情况更为严峻,对所有检测的抗生素都表现了极高的耐药率,对亚胺培南和美洛培南的耐药率也很高,可能与该院ICU的不动杆菌感染由几个同源的高耐药的菌株传播有关,表现出耐药性十分严重的流行发生。结论严格执行消毒隔离制度,寻找感染源头,通过根除医院环境中的不动杆菌,阻止不动杆菌感染扩散。

Objectives To study the cause of nosocomial outbreak and the antimierobial resistance of Acinetobacter spp. isolated from intensive care unit （ICU） patients, for preventing the nosocomial infection of Acinetobacter spp. Methods To review the Acinetobacter spp. collected from patients in ICU during 2004. Results The ratio of Acinetobacter spp. to all the bacteria isolated was the highest （26.7%）, and respiratory tract was the major source （79.1%）. The antimicrobial resistance was very serious, there was a high resistant rate to all antimicrobial, including Imipenem and Meropenem, which relates to the prevalence of congeneric Acinetobacter with high antimierobial resistance,leading to its outbreak. Conclusions Enforcing the system of strict sterilization and segregation and searching for the source of infection were the main measures to eradicate nosocomial Acinetobacter and prevent its spread.