重症监护病房与非重症监护病房鲍曼不动杆菌分布和耐药性比较

Comparison of specimens of ICU and the ICU Acinetobacter baumannii distribution and drug resistance analysis

目的：比较ICU与非ICU鲍曼不动杆菌分布和耐药性。方法回顾性对比分析ICU分离出的1079株和非ICU分离出的8413株细菌；细菌鉴定和药敏试验采用VITEK 2 Compact全自动细菌培养鉴定仪。结果 ICU分离鲍曼不动杆菌最多，构成比（29．2％）明显高于非ICU（6．2％）（χ2＝625．955，P＜0．05）；ICU耐亚胺培南鲍曼不动杆菌（IRAB）的检出率（91．7％）明显高于非ICU（43．5％）（χ2＝193．541，P＜0．05）；ICU和非ICU分离细菌的标本均主要来源于痰液，构成比分别为64．0％和32．9％。 ICU和非ICU分离的鲍曼不动杆菌对阿米卡星耐药率较低（20．0％～21．6％），ICU分离的鲍曼不动杆菌对三、四代头孢菌素、酶抑制剂复合药物、碳青霉烯类、喹诺酮类等广谱抗菌药物的耐药率明显高于非 ICU （χ2＝146．124、104．409、253.171、195．646、186．580，均P＜0．05）。结论多重耐药鲍曼不动杆菌在ICU的检出率高，应加强细菌监测，合理用药，降低细菌的耐药性。

Objective To compare distribution and drug resistance of Acinetobacter baumannii specimen in the intensive care unit（ICU） and the ICU.Methods Retrospective analysis ICU of 1 079 strains isolated and the 8 413 strains of bacteria isolated from ICU , Bacteria identification and drug sensitive test instrument using VITEK 2 Compact automatic bacterial culture identification .Results Most ICU Acinetobacter baumannii separation , form （29.2%） was significantly higher than the ICU （6.2%）,the difference was statistically significant （χ2 =625.955, P〈0.05）.ICU imine resistant Acinetobacter baumannii from south （IRAB）detection rate（91.7%）was significantly higher（43.5%） than the ICU,difference was statistically significant （χ2 =193.541,P〈0.05）;Specimens of ICU and the ICU isolated bacteria were mainly comes from sputum ,constitute a ratio of 64.0%and 32.9%respectively. ICU and the separation of the ICU Acinetobacter baumannii to amikacin resistant rate was low （20.0%-21.6%）,the separation of ICU Acinetobacter baumannii for three or four generation of cephalosporin , composite inhibitor drugs , penicillium carbon alkene ,quinolone antibacterial drugs ,significantly higher percentages of ICU ,difference was statis-tically significant（χ2 =146.124,104.407,253.171,195.646,186.580,all P〈0.05）.Conclusion Multiple drug resistance of Acinetobacter baumannii in ICU detection rate is high ,the bacteria monitoring should be strengthened , and the rational use of drugs ,reduce the drug resistance of bacteria .