下呼吸道鲍曼不动杆菌感染株耐药性分析

Analyzing the Dgug-resistance of Acinetobacter Baumannii in Lower Respiratory Tract Infection

目的对近3年来我院下呼吸道感染患者分离的鲍曼不动杆菌进行耐药性分析,探讨泛耐药菌株感染的临床治疗用药方案。方法用常规细菌培养方法从患者痰液或气道插管刷出物分离细菌,法国ATB细菌仪鉴定菌种,用K-B法对14种常用抗菌药物进行体外药敏测定。结果3年中共分离鲍曼不动杆菌248株(不重复病例),药敏试验结果表明,除亚胺培南、美罗培南和头孢哌酮/舒巴坦的耐药率较低(11.7%～15.3%)外,其他抗菌药物的耐药率普遍很高(40.3%～89.5%)。其中耐4类或4类以上药物的泛耐药株(PDRA)占37.1%。结论鲍曼不动杆菌是下呼吸道感染的主要病原菌,临床高检出率和高耐药率给抗菌治疗带来极大的困难,严格各项无菌操作制度,加强细菌耐药性的监测,提倡合理使用抗菌药物,是预防和控制鲍曼不动杆菌病区流行的有效措施。

Objective By analyzing the dgug - resistance of Acinetobacter baumannii got from clinic in recent 3 years to study the therapy method of pan resistant bacteria. Method Bacteria was got from sputum or traehea pipe of patients normally, identified with ATB and test 14 common antibiotic drugs by K - B method. Result All the drug - sensitive test results of 248 bacteria in 3 years show that drug- resistance rate is high （40.3% -89.5% ） except for IPM ,IMI and sulbactam（ 11.7% -15.3% ） ,and pan resistant bacteria （resist 4 or more kinds of antibiotic drugs） is 37.1%. Conclusion Acinetobacter baumannii is the main pathogen of lower respiratory tract infection . The high picks out rate and high drug resistance get great trouble to therapy. We need to make a strict standards of asepsis operation, strengthen monitoring the drug resistance and advocate to use antibiotic drugs reasonably, so that we can prevent and control the prevalence of Aeinetobaeter baumannii.