基层医院 ICU 鲍曼不动杆菌的感染现况及耐药性分析

Survey on Acinetobacter Baumannii Infection and Analysis of Drug Susceptibility in ICU

目的：了解基层医院 ICU 鲍曼不动杆菌（Acinetobacter baumannii ，Ab）的感染现状和评价《抗菌药物临床应用专项整治活动方案》的实施效果，为临床医生合理应用抗菌药物提供科学依据。方法用 VITEK2微生物分析系统对小榄医院2012年1月-2013年12月 ICU 患者标本中分离的鲍曼不动杆菌进行药敏分析，比较分析《抗菌药物临床应用专项整治活动方案》2012年（干预前）和2013年（干预后）ICU 鲍曼不动杆菌的耐药性。结果2012年（干预前）和2013年（干预后）从小榄医院 ICU 标本分离的鲍曼不动杆菌分别为71株和57株，其主要来源于呼吸系统感染，分别占94.4％和84.2％。该项方案干预后，多重耐药鲍曼不动杆菌的检出率由77.5％降为66.7％；鲍曼不动杆菌对头孢吡肟、头孢他啶、头孢曲松、妥布霉素和复方新诺明等的耐药率显著降低（χ^2＞3.84，P ＜0.05）。结论该项方案干预后，ICU 患者标本分离的鲍曼不动杆菌对常用14种抗菌药物的耐药率低于干预前，其中有5种抗菌药物的耐药率显著降低。

Objective To investigate the current situation on the infection of Acinetobacter baumannii in ICU and evaluate the efficiency of resistance control project which was performed in Xiaolan hospital,so as to provide scientific basis for clinical rational use of antibiotics.Methods Used VITEK-2 microbiology analysis system for the pathogen identification and drug sensitivity.Compared drug resistance of Acinetobacter baumannii isolated from the samples of ICU patients in 2012 （before the project executed）with that in 2013 （after the project executed）.Results 71 strains and 57strains Acinetobacter bauman-nii were isolated from the ICU in 2012 （before the project executed）and in 2013 （after the project executed）respectively, which majorly isolated from the samples of respiratory system,and occupied 94.4% and 84.2% respectively.The infection rate of multi-resistant Acinetobacter baumannii was decreased from 77.5% to 66.7%,and the resistance rate of Acinetobact-er baumannii to cefepime,ceftazidime,cefatriaxone,tobramycin and cotrimoxazole decreased distinctly after the implementa-tion of drug resistance control management （χ^2 〉 3.84,P 〈0.05）.Conclusion The drug resistance rates of Acinetobacter baumannii to 14 kinds of routine antibacterial drugs in 2013 were lower than that in 2012 in ICU.Among them,the drug re-sistance rates of Acinetobacter baumannii to 5 kinds of antibacterial drugs decreased distinctly.