重症监护病房下呼吸道医院感染鲍氏不动杆菌的耐药性分析

Antibiotic Resistance Analysis in Nosocomial Infections with Acinetobacter baumannii from Lower Respiratory Tract in ICU

目的调查重症监护病房(ICU)下呼吸道医院感染鲍氏不动杆菌的耐药情况,指导临床医师合理用药。方法采用K-B法对109株ICU患者下呼吸道标本分离的鲍氏不动杆菌进行抗菌药物敏感性测定,依据美国临床实验室标准化研究所(CLSI)2007年标准判断结果,同时用标准菌株进行质量控制。结果对鲍氏不动杆菌敏感率最高的是头孢哌酮/舒巴坦(77.1%),其次为亚胺培南(57.8%)和美罗培南(54.9%),其他抗菌药物敏感率<50.0%,耐药菌株存在较严重的交叉耐药现象,且ICU已检测出泛耐药菌株。结论ICU下呼吸道医院感染的鲍氏不动杆菌耐药现象非常严重,应继续加强对该菌的监测与控制,严防耐药菌株在ICU暴发流行。

OBJECTIVE To investigate antibiotic resistance in nosocomial infections with Acinetobacter baumannii from lower respiratory tract in the intensive care unit（ICU） and guide clinically rational use of drug.METHODS Antibiotics susceptibility tests in 109 clinical isolates of A.baumannii from lower respiratiory tract were performed by K-B disk diffusion method.The results were judged according to CLSI 2007.As controls,standard strain was used simultaneously.RESULTS The sensitivity rate to cefoperazone/sulbactam was the highest,arriving at 77.1% and followed by imipenem（57.8%） and meropenem（54.9%）.The other antibiotics were below 50.0%,generally.The serious cross-resistance phenomenon was in present.Pan-resistant strains had been detected.CONCLUSIONS The drug-resistant status in nosocomial infections with A.baumannii from lower respiratory tract in ICU is very serious.We should continue to strengthen the monitoring of the antibiotic resistance and prevent the outbreak epidemics of drug resistant strains in ICU.