老年患者医院下呼吸道感染碳青霉烯耐药鲍曼不动杆菌流行特征及耐药性分析

Investigation of the epidemiological characteristics and drug resistance of carbapenem-resistance A.baumannii in elderly patients with lower respiratory tract infection

目的了解医院下呼吸道感染碳青霉烯耐药鲍曼不动杆菌(CRAB)的分布及耐药状况。方法回顾性分析2008年1月至2009年12月我院下呼吸道感染CRAB的流行特征。测定菌株对抗菌药物的敏感性。结果分离的CRAB大部分来自下呼吸道(82.6%),科室送检标本ICU最多(59%)。连续2年资料显示,月检出率表现为5～9月份较高。药敏结果显示,12种抗菌药物中耐药率较低的前2位依次为阿米卡星(AMK)和米诺环素(MH),分别为30.12%和43.48%。结论 CRAB以下呼吸道感染为主,集中分布于ICU,炎热时节检出率高,细菌耐药严重,宜根据药敏试验结果合理选用抗生素。

Objective To investigate the prevalence and antibiotic resistance of Carbapenem-resistance A.baumannii（CRAB） in elder patients with lower respiratory infections.Methods The reported epidemic data from Jan 2008 to Dec 2009 were analyzed retrospectively.Results Most of CRAB were isolated from lower respiratory tract（82.6%）.The strains were mainly isolated from ICU（59%）.Our data from consecutively 2 years showed that higher detection rate was in summer.The antibiotic susceptibility testing showed that Amikacin（with 30.12% drug resistance） and Minocyline（with 43.48% drug resistance） were the lowest drug resistant agents against CRAB.Conclusions The main site of CRAB is lower respiratory infection.The CRAB strains are mainly isolated from ICU.Drug resistance is serious,we should rationally use antibiotics according to susceptibility test results.