重症监护病房呼吸机相关性肺炎中鲍曼不动杆菌耐药性的动态分析

Analysis of drug resistance of Acinetobacter baumanii in patients with ventilator-associated pneumonia in intensive care unit

目的探讨重症监护病房呼吸机相关性肺炎(VAP)中鲍曼不动杆菌(Acinetobacter baumannii,Ab)的分布特点和耐药性,为临床防治鲍曼不动杆菌感染提供依据。方法对机械通气>48 h的79例患者的气管抽吸物(ETA)进行细菌定量培养和药敏测定。结果回顾性分析79例VAP患者ETA培养出病原菌214株,其中鲍曼不动杆菌79株(36.9%)。鲍曼不动杆菌对常见抗菌药物的耐药率呈上升趋势,出现较多多重耐药和泛耐药菌株。头孢哌酮/舒巴坦和亚胺培南的耐药率分别是55.6%和68.4%,均呈上升趋势。结论鲍曼不动杆菌是VAP常见病原菌之一,鲍曼不动杆菌的耐药性呈上升趋势,特别是多重耐药和泛耐药菌株,应引起高度重视。

Objective To investigate the distribution and drug resistance characteristics of Acinetobacter baumannii in patients with ventilator-associated pneumonia（VAP） in intensive care unit and provide guidance for clinical treatment.Methods The endotracheal aspirates of 79 patients received mechanical ventilation for more than 48 hours were cultured with a quantitative method and their antibiotic susceptibility was detected.Results Among 214 strains of pathogens isolated from the 79 patients,A.baumannii accounted for 36.9%,which showed high rate of resistance to routine antimicrobial agents.A number of pandrug-resistant and multidrug-resistant A.baumannii were found.Its resistance rate to cefoperazone sulbactam and imipenam were 55.6% and 68.4% respectively,with a remarkable uptrend.Conclution A.baumannii is one of the most common pathogens of ventilator-associated pneumonia.The antibiotic resistance of A.baumannii is still increasing,especially that of the MDR and PDR strains of A.baumannii,to which a great attention should be paid.