重症监护病房鲍曼不动杆菌感染现状及耐药性分析

Analysis of infection status and drug resistance of Acinetobacter baumannii in ICU

目的探讨重症监护病房(ICU)鲍曼不动杆菌(ABA)的临床分布及耐药性、特征。方法菌株来源2011年1月至2012年2月从患者标本中培养出373株ABA。ABA分离、鉴定按照《全国临床检验操作规程》进行;细菌鉴定和药敏试验采用法国生物梅里埃VITEK-2系统进行,以铜绿假单胞菌ATCC27853为质控菌株,依据CLSI的标准对结果进行判定。结果共检出ABA 373株,检出率为21.4%。ABA在呼吸道标本中检出率占首位,达89%;同一标本检出鲍曼不动杆菌同时并发其他感染50.7%,ABA对临床常用抗菌药物均产生了非常严重的耐药性,对亚胺培南和美罗培南耐药率分别为73.5%、82.0%。结论为控制ABA耐药性不断增长的不良趋势应及时分析ABA临床分布特征及耐药性,主张联合用药,坚持动态监测药品DDD值。

Objective To investigate the clinical distribution and drug resistance characteristics of Acinetobacter baumannii （ABA） in ICU. Methods Strain during January 2011 to February 2012 specimens from patients cultured 373 plants of ABA. ABA was separated and identified according to ＂the national clinical laboratory standards＂ ~ the bacteria identification and drug sensitivity were tested by using the French bioMerieux VITEK-2 system,Pseudomonas aeruginosa strains of ATCC27853 were as quality con- trol,the result was judged according to the CLSI standard. Results There were 373 strains of ABA,the detection rate was 21.4%. ABA detection rate in respiratory specimens occupied the first place, up to 89 % ;the same specimen detection of ABA infection com- plicated with other bacteria was 50.7 %, ABA produced very serious resistance to clinical antibiotic,the resistance rates to imipenem and meropenem were 73.5 % and 82.0 % respectively. Conclusion To control ABA resistance growing trend we should analyze the clinical distribution feature and drug resistance in ABA, advocate drug combination and insist on dynamic monitoring drug DDD value,