神经内科患者医院感染鲍氏不动杆菌的耐药性调查分析

Antimicrobial resistance of Acinetobacter baumannii causing nosocomial infections in department of neurology

目的研究神经内科住院患者医院感染鲍氏不动杆菌(ABA)的抗药性,为医师控制感染选择抗菌药物提供依据。方法无菌手法收集神经内科住院患者感染性标本;ABA培养按照临床微生物学检验的常规操作方法进行,细菌采用MicroScan AutoSCAN4自动微生物鉴定系统进行鉴定;药敏试验采用WHO指定的纸片扩散法(K-B法),抑菌圈直径的测量和敏感、中介、耐药判断依据CLSI的最新折点分析,药敏数据统计运用WHONET5.5软件版本处理。结果神经内科流行的182株ABA在呼吸道标本中检出118株,检出率达到64.8%;ABA对临床抗菌药物均产生了严重的抗药性,检出泛耐药菌株41株,检出率为22.5%;检出耐碳青霉烯类菌株43株,检出率为23.6%。结论医院务必加大对《抗菌药物临床应用管理办法》的执行力,重视感染病原学检测的相关管理,培训提升临床医师抗菌药物处方水平,以扭转细菌耐药性不断增长的危险倾向。

OBJECTIVE To investigate the antimicrobial resistance of Acinetobacter baumannii （ABA） causing nos-ocomial infections in department of neurology,so as to provide the scientific evidence for clinical control of it.METHODS Infective specimens from the inpatients were collected by the asepsis technique. ABA culturation wasperformed by the routine methods. MicroScan AutoSCAN4 system was used to identify the strains. The antibioticsusceptibility testings were performed by disk diffusion methods. Diameter of inhibition zone were measured andsusceptibility testing results were assessed by the newest breakpoints of CLSI. The WHONET 5. 5 software wasused to process the data. RESULTS Of 182 ABA prevailing in department of neurology, 118 strains ABA （64. 8%）were isolated from respiratory tract. ABA isolates were highly resistant to clinical used antibotics. Panresistantstrains （41, 22. 5%） were found, and 43 carbapenem-resistant strains （23. 6%） were isolated. CONCLUSION Thehospitals should strengthen execution of Administrative Measures For Clinical Use of Antibiotics , attach importance to etiological detection,and raise the level of prescription so as to turn round the increasing dangerous tend-ency of antimicrobial resistance.