55例鲍曼不动杆菌血流感染的临床分析

Clinical Analysis of 55 Cases of Acinetobacter Baumannii Bloodstream Infection

目的：探讨鲍曼不动杆菌血流感染患者的临床特征、感染危险因素及细菌耐药性,为临床合理用药和控制医院感染提供指导。方法：回顾性分析某院2011~2014年鲍曼不动杆菌血流感染患者的临床及微生物资料,包括患者基本情况、临床特点、基础疾病、微生物学特征及抗菌药物使用情况等。结果：收集到55例鲍曼不动杆菌血流感染患者,其中老年人占47.27%;基础疾病主要为脑血管疾病19例（34.55%）,糖尿病15例（27.27%）;科室分布重症医学科最多占16.36%,18例患者进行了中央静脉置管。所有分离菌株对第三代头孢菌素耐药率最高,头孢哌酮/舒巴坦耐药率最低。结论：鲍曼不动杆菌血流感染多发于重症患者,对怀疑有鲍曼不动杆菌血流感染的患者应及时进行血培养,可经验性选用头孢哌酮/舒巴坦。同时需重视医院感染的预防与控制。

Objective： To investigate the clinical distribution characteristics,risk factors and bacterial drug resistance of the blood stream infection of Acinetobacter,and provide guidance for clinical rational drug use and control of hospital infection. Methods： A retrospective analysis in 2011-2014 patients with acinetobacter baumannii bloodstream infections during the period of clinical and microbiological data,included basic information of patients,the clinical feature,the underlying diseases,microbilogical characteristics and usage of antimicrobial agents,etc. Results： 55 patients with acinetobacter baumannii bloodstream infections in the elderly accounted for 47. 27%; Basic diseases mainly for cerebrovascular disease19 cases（ 34. 55%）,diabetes 15 cases（ 27. 27%）. Distribution department for the most intensive medicine,accounted for 16. 36%,18 cases underwent the central venous catheter. All strains to participate in screening of antimicrobial agents,the third generation cephalosporin resistant rate is highest,cefoperazone shu ba resistance to a minimum. Conclusion： Acinetobacter baumannii bloodstream infection multiple in critically ill patients,suspected with Acinetobacter baumannii bloodstream infections in patients with blood culture,empirical selection of cefoperazone sodium and sulbactam sodium. Meanwhile we should pay attention to the prevention and control of hospital infection.