外科ICU鲍氏不动杆菌感染分析及控制

Acinetobacter baumanniiinfections in surgical ICU and control of nosocomial infections

目的了解外科ICU鲍氏不动杆菌感染及其对抗菌药物的耐药性,为临床治疗和感染控制提供参考。方法将2010年1-5月医院外科ICU住院患者送检的各类标本进行分离培养,对分离出的114株鲍氏不动杆菌的标本来源、药敏检测结果进行分析。结果来自痰、咽拭子、尿液标本的鲍氏不动杆菌共114株,占送检阳性标本的33.9%,标本来源以痰标本为主,占90.4%;在常规监测的抗菌药物中,总体耐药率较高,对头孢曲松、头孢他啶、庆大霉素和哌拉西林、头孢吡肟的耐药率最高,达到98.2%,其次是环丙沙星和左氧氟沙星耐药率为96.4%。结论鲍氏不动杆菌已成为外科ICU的主要致病菌之一,其中以泛耐药鲍氏不动杆菌为主,因此,应重视该菌感染及耐药性监测情况,切断传播途径,预防医院感染的发生。

OBJECTIVE To understand Acinetobacter baumannii infections in surgical ICU and its drug resistance to 16 kinds of antimicrobial agents,so as to provide reference for clinical treatment and infection control.METHODS Various specimens obtained from surgical ICU inpatients from Jan 2010 to May 2010 were isolated and cultured,the specimens sources of the 114 isolated Acinetobacter baumannii and the results of drug susceptibility testing were analyzed.RESULTS There were 114 strains of Acinetobacter baumannii isolated from sputum,throat swabs,and urine specimens,accounting for 33.9% of positive samples for testing.The specimens were mainly from sputum samples,accounting for 90.4%.The overall resistance rate to 16 antimicrobial agents for routine testing was relatively high,the resistance rates to ceftriaxone,ceftazidime,gentamicin,and piperacillin and cefepime were the highest,reaching up to 98.2%,followed by ciprofloxacin and levofloxacin（96.4%）.CONCLUSION A.baumannii has become one of the main pathogens in surgical ICU,as the pandrug-resistant A.baumannii is dominant,the infection and surveillance for drug resistance should be attached great importance in order to cut off the transmission and prevent nosocomial infections.