肿瘤科医院感染鲍氏不动杆菌的耐药性调查分析

Antimicrobial resistance of acinetobacter baumanii causing nosocomial infection in department of tumor

目的了解医院肿瘤科患者医院感染鲍氏不动杆菌(ABA)的耐药现状,为临床医师合理使用抗菌药物提供科学依据。方法细菌培养鉴定严格按照《全国临床检验操作规程》进行;药敏试验采用CLSI推荐的K-B法,采用2006-2009年折点判读结果。结果 217株ABA以呼吸道标本分离率最高,占65.0%;脓液和分泌物第2位,占13.4%;穿刺液(脑脊液、胸水、腹水、心包液)第3位,占8.3%;肿瘤科ABA已出现7.8%的泛耐药菌株;对碳青霉烯类抗菌药物亚胺培南和美罗培南耐药率分别为22.1%、24.9%;对常用抗菌药物已产生了严重的耐药性。结论医院应高度重视细菌耐药性的动态监测,严防泛耐药菌株医院感染暴发流行。

OBJECTIVE To understand the antimicrobial resistance in nosocomial infection caused by Acinetobacter baurnanii （ABA） from department of tumor to provide the scientific evidence for clinically reasonable use of antibiotics. METHODS Referring to National Guide to Clinical Laboratory Operation Procedure, bacterial culture and identification were performed. And susceptibility testing was performed by K-B methods recommended by CLSI. The test results were assessed according to CLSI 2006--2009 breakpoint. RESULTS The detection rates in various kinds of specimen were in the following order of frequency： specimen from respiratory tract （65.0%）, liquor purls and secretion （13.4 %）, pucture fluid （cerebrospinal fluid, pleural fluid, ascites and pericardial fluid） （8.3%）. Susceptibility testing results indicated that 7.8G of ABA from department of tumor were pan-resistant strains. The resistance rates of imipenem and meropenem were 22. 1% and 24. 9%, respectively. The serious antimicrobial resistance occurred in ABA against the commonly used antibiotics. CONCLUSION It should attach importance to monitoring of antimierobial resistance to prevent the outbreak of nosocomial infection caused by pan- resistant strains.