多药耐药鲍氏不动杆菌耐药性分析

Drug resistance of multidrug-resistant Acinetobacter baumannii

目的探讨住院患者感染多药耐药鲍氏不动杆菌的耐药性,以降低其感染率。方法分析2012年5月-2013年6月80例患者标本分离鲍氏不动杆菌耐药性及感染因素。结果耐药率最低为头孢哌酮/舒巴坦,占25.00%;敏感率由高到低依次为亚胺培南58.75%、头孢哌酮/舒巴坦48.75%、哌拉西林/他唑巴坦38.75%、左氧氟沙星36.25%、头孢他啶32.50%;感染多药耐药鲍氏不动杆菌患者药物治疗以碳青霉烯类抗菌药物为多,其中亚胺培南占65.00%,而头孢哌酮/舒巴坦占50.00%,氨基糖苷类占40.00%,且有20.00%患者给予头孢哌酮/舒巴坦联合氨基糖苷类治疗,联合治疗效果相比单药治疗较好;感染因素主要为机械通气、静脉插管、机械通气联合静脉插管以及抗菌药物的应用。结论对确诊感染多药耐药鲍氏不动杆菌患者应积极治疗原发病,尽量选择头孢哌酮/舒巴坦治疗以提高疗效。

OBJECTIVE To investigate the drug resistance of multidrug-resistant Acinetobacter baumannii causing infections in hospitalized patients so as to provide guidance for clinical treatment and reduction of infection rate.METHODS Totally 80 patients who were treated in the hospital from May 2012 to Jun 2013 were enrolled in the study,then the drug resistance of the A.baumannii sisolates from the specimens was analyzed,and the risk factors for the infections were observed.RESULTS The drug resistance rate to cefoperazone-sulbactam was the lowest（25.00%）.The drug susceptibility rates to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,levofloxacin,and ceftazidime were 58.75%,48.75%,38.75%,36.25%,and 32.50%,respectively.The carbapenems were the most commonly used antibiotics for the treatment of the multidrug-resistant A.baumannii infections.Of the patients who used the carbapenems,65.00% used imipenem,50.00% used cefoperazone-sulbactam,40.00%used aminoglycosides,and 20.00% used cefoperazone-sulbactam combined with aminoglycosides;the effect of the combined drug therapy was better than that of the one-drug therapy.CONCLUSION For the patients with conformed multidrug-resistant A.baumannii infections,it is necessary to actively treat the primary disease and choose cefoperazone-sulbactam for the treatment.