重症监护病房鲍曼不动杆菌感染特点及防控策略

The infection characteristic and prevention/control of acinetobacter baumanii strains in ICU

目的分析重症监护病房中鲍曼不动杆菌的易感因素及其耐药性,探讨鲍曼不动杆菌交叉感染防控的新思路及有效方法。方法回顾性分析本院重症监护病房2007年9月至2009年9月鲍曼不动杆菌的感染特点及其体外药敏试验,了解感染危险因素。结果免疫力低下、严重创伤、侵入性操作、使用呼吸机、长时间住院等因素导致重症监护室中鲍曼不动杆菌严重交叉感染。在体外药敏试验中,仅头孢哌酮/舒巴坦和阿米卡星的敏感性较高,分别为65.09%和72.64%。结论加强环境消毒、加大医务人员院内感染知识的教育、严格执行洗手制度、合理使用抗生素、保护易感人群,采用降阶梯防控策略对控制重症监护室鲍曼不动杆菌的交叉感染及防治具有非常重要意义。

Objective To analyze the easy infection factors and resistance of A.baumanii in ICU,in order to explore a new idea of effective prevention and control of A.baumanii cross infection.Methods Specimens were collected from ICU patients with infections from Sept.2007 to Sept.2009.The infection characteristics were detected and the drug sensitivity was tested to investigate the dangerous infection factors retrospectively.Results The factors of low immunity,serious wound,invading operation and using respiratory machine lead to the serious cross-infection of A.baoumanii in ICU.In the vitro drug susceptibility test,only the sensitive rates of cefoperazone/sulbactam and amikacin were higher,being 65.09% and 72.64% respectively.Conclusion It is of a great significance in the prevention and control of A.baumanii cross-infection in ICU to strengthen the environment disinfection,enhance the education of medical staff nosocomial infection knowledge,execute the hand-wash system strictly,use the antibiotics rationally,protect the easy-infection crowds and adopt De-escalation prevention and control strategy.