ICU患者血流感染鲍氏不动杆菌耐药性分析

Drug resistance of Acinetobacter baumannii causing bloodstream infections in ICU patients

目的了解重症监护病房(ICU)鲍氏不动杆菌血流感染的耐药性,指导临床控制鲍氏不动杆菌感染,合理使用抗菌药物。方法对2009年1月-2013年12月ICU住院患者送检血培养阳性标本,对检出的鲍氏不动杆菌采用法国生物梅里埃公司VITEK-2Compact全自动微生物分析仪进行鉴定,采用MIC法测定常用抗菌药物的敏感性,所有资料采用SPSS11.0软件进行统计分析。结果 2009年1月-2013年12月ICU共送检血培养标本35 829份,其中有49份血培养标本检出鲍氏不动杆菌,阳性检出率为0.14%,鲍氏不动杆菌对多黏菌素敏感性最好,对氨苄西林/舒巴坦、氨曲南、环丙沙星、头孢曲松的敏感率均很低。结论鲍氏不动杆菌在抗菌药物治疗过程中极易形成多药耐药,临床应慎重选用抗菌药物,血流鲍氏不动杆菌感染预后差,ICU应加强消毒隔离措施,阻断各种可能的传播途径。

OBJECTIVE To understand the drug resistance of Acinetobacter baumannii causing bloodstream infec‐tions in intensive care units （ICUs） so as to provide guidance for clinical control of A .baumannii infection and for reasonable use of antibiotics .METHODS The positive blood culture specimens were submitted from the patients who were hospitalized the ICUs from Jan 2009 to Dec 2013 ,then the isolated A .baumannii strains were identified by using VITEK‐2 Compact automatic microorganism analyzer of BioMerieux ,France ,the drug susceptibility to the commonly used antibiotics was determined with the use of MIC method ,and all the data were statistically ana‐lyzed by using SPSS11 .0 software .RESULTS Of totally 35 829 blood culture specimens submitted from the ICUs from Jan 2009 to Dec 2013 ,the A .baumannii strains were cultured from 49 blood specimens ;with the positive rate of 0 .14% .The A .baumannii was most susceptible to polymyxin ,and the drug susceptibility rates to ampicil‐lin‐sulbactam ,aztreonam ,ciprofloxacin ,ceftriaxone ,and cefepime were very low .CONCLUSION The A .bauman‐nii strains tend to be multidrug‐resistant during the antibiotics therapy .As for the poor prognosis of the patients with A .baumannii bloodstream infections ,it is necessary for the hospital to reasonably use antibiotics ,strengthen the disinfection and isolation in the ICUs ,and cut the various possible transmission routes .