ICU患者鲍氏不动杆菌医院感染的耐药性分析

Drug resistance of Acinetobacter baumannii causing nosocomial infections in ICU patients

目的探讨ICU患者鲍氏不动杆菌(ABA)医院感染的分布特征及耐药性,为指导临床预防感染与合理选用抗菌药物提供依据。方法选取2013年1-12月ICU患者分离的医院感染性ABA82株,对其分布与耐药性进行统计分析。结果 ABA在ICU患者的检出率较高,其中86.58%标本来源于下呼吸道;该菌多药耐药现象严重,82株ABA只有对多黏菌素耐药率为0,对阿米卡星耐药率12.20%,对头孢哌酮/舒巴坦耐药率33.33%,对磺胺甲噁唑/甲氧苄啶、亚胺培南、美罗培南、头孢吡肟、环丙沙星、他唑巴坦/哌拉西林、左氧氟沙星、克拉维酸/替卡西林耐药率均>90.00%;泛耐药ABA检出10株,占12.19%。结论 ICU患者医院感染ABA多药耐药严重,医院应加强对ABA耐药性的监测,实施有效预防与控制措施,尽可能减少并延缓泛耐药株及多药耐药株的产生,防止多药耐药ABA医院感染暴发流行。

OBJECTIVE To explore the distribution and drug resistance of the Acinetobacter baumannii causing nos‐ocomial infections in the ICU patients so as to provide guidance for clinical prevention of infections and reasonable use of antibiotics .METHODS A total of 82 strains of A .baumannii that were isolated from the ICU patients from Jan 2013 to Dec 2013 were included in the study ,then the distribution and drug resistance of the A .baumannii strains were statistically analyzed .RESULTS The isolation rate of the A .baumannii was high in the ICU patients , and 86 .58% of the specimens were obtained from the respiratory tract .The A .baumannii was highly multidrug‐resistant ;the drug resistance rate of the 82 strains of A .baumannii to colistin was 0 ,amikacin 12 .20% ,cefopera‐zone‐sulbactam 33 .33% ;the drug resistance rates to sulfamethoxazole‐trimethoprim , imipenem , meropenem , cefepime ,ciprofloxacin , tazobactam‐piperacillin , levofloxacin , and clavulanic acid‐ticarcillin were more than 90 .00% . Totally 10 strains of pandrug‐resistant A .baumannii have been isolated , accounting for 12 .9% . CONCLUSION The A .baumannii causing nosocomial infections in the ICU patients is highly multidrug‐resistant . It is necessary for the hospital to strengthen the surveillance of the drug resistance of the A .baumannii ,take effec‐tive prevention measures ,and delay the emergence of drug‐resistant and multidrug‐resistant strains so as to pre‐vent the prevalence of nosocomial infections due to the multidrug‐resistant A .baumannii .