ICU多重鲍曼不动杆菌感染的流行病学调查及耐药性研究

Epidemiological investigation and drug resistance of ICU multiple Acinetobacter infection

目的探讨ICU多重鲍曼不动杆菌感染的流行病学特征及耐药性。方法回归分析121例鲍曼不动杆菌感染ICU患者临床资料,对分离菌株进行鉴定、药敏试验。结果 121株鲍曼不动杆菌均对米诺环素、多粘菌素B均敏感,部分对头孢哌酮/舒巴坦、亚胺培南敏感。多耐组和非多耐组死亡率差异有统计学意义(P<0.05),且两组年龄、性别、住院时间、混合感染、机械通气、碳青霉烯类抗菌药物、合并慢性阻塞性肺疾病及糖尿病差异均有统计学意义(P<0.05)。年龄、混合感染、机械通气、碳青霉烯类抗菌药物及合并慢性阻塞性肺疾病是多重耐药鲍曼不动杆菌感染的独立危险因素(P<0.05)。结论 ICU多重鲍曼不动杆菌菌株检出率、致死率高,高龄、混合感染、机械通气、碳青霉烯类抗菌药物及合并慢性阻塞性肺疾病是其独立危险因素。

Objective To investigate the epidemiological characteristics of ICU multiple Acinetobacter infection and drug resistance. Methods Regression analysis of 121 cases of Acinetobacter baumannii infection in ICU patients clinical infor- mation, identification, susceptibility testing on isolates. Results All of 121 Aeinetobaeter baumannii are minocycline, and more sticky amphotericin B were sensitive, in part to cefoperazone / sulbactam, imipenem. Multi-resistant group and the non-muhi-resistant group mortality difference was statistically significant （P 〈 0.05）, age, gender, duration of hospitaliza- tion, mixed infection, mechanical ventilation, carbapenem antibacterial drugs, chronic obstructive pulmonary disease and diabetes there were significant differences （P 〈 0.05）. Age, mixed infection, mechanical ventilation, carbapenem antibiotics and with chronic obstructive pulmonary disease was an independent risk factor for multi-drug resistant Acinetobacter bau- mannii infection （P 〈 0.05）. Conclusion ICU multiple Bowman Acinetobacter strain detection rate, death rate, the elderly, mixed infection, mechanical ventilation, carbapenem antimicrobial agents and with chronic obstructive pulmonary disease is an indeoendent risk factor.