重症加强治疗病房鲍曼不动杆菌耐药性分析及其与中医证候的关系

Analysis of drug resistance in Acinetobacter baumannii in intensive care unit and relation with traditional Chinese medicine syndrome

目的:探讨重症加强治疗病房(ICU)鲍曼不动杆菌耐药性特点及其与中医证候的关系。方法:分离2005年3月—2006年2月本院ICU住院患者痰液标本中66株鲍曼不动杆菌,采用K-B纸片扩散法进行体外药敏试验,分析鲍曼不动杆菌感染及与中医证候的关系。结果:除亚胺培南外(敏感率为83.33%),66株鲍曼不动杆菌对多种抗菌药物耐药(敏感率<40.00%)。鲍曼不动杆菌感染者的中医证候全部为虚实夹杂证,以热郁证(42.42%)、痰阻证(34.85%)、气虚证(39.39%)、阴虚证(37.88%)为主。结论:对多重耐药鲍曼不动杆菌感染的患者应以亚胺培南作为一线抗菌药物,同时可考虑采用中医辨证论治辅助治疗。

Objective： To assess the relationship between the characteristic of drug resistance in Acinetobacter baumannii and the syndrome of traditional Chinese medicine （TCM） in intensive care unit （ICU）. Methods： Sixty- six strains of Acinetobacter baumannii were isolated from sputum specimens of patients in our ICU from March 2005 to February 2006. The data of the drug sensitivity test in vitro was analyzed. The relation between the syndrome of TCM and drug resistance in Acinetobacter baumannii was probed. Results： The 66 strains of Acinetobacter baumannii were drug resistant to multiple kinds of anti - bacterial drugs （sensitivity rate 〈40.00%） except imipenem （sensitivity rate 83.33%）. The syndromes of TCM of all patients infected with Acinetobacter baumannii were vacuity- repletion complex （虚实夹杂证）. The main TCM syndromes were phlegm obstruction （痰阻证, 34.85%）, heat depression （热郁证, 42.42% ）, Qi vacuity （气虚证, 39.39% ）, Yin vacuity （阴虚证, 37.88 % ）. Conclusion ： Imipenem is the first line anti - bacterial drug to be selected for the treatment of cases infected with Acinetobacter baumannii with multiple drug resistance. In the mean time, identifying patterns of various syndromes in TCM to determine the Chinese medicinal drug treatment for help might be considered for such patient＇s treatment.