疑似多重耐药鲍曼不动杆菌暴发病例抗菌药物使用分析

An suspected outbreak of multi-drμg resistant acinetobacter baumannii analysis of antimicrobial drμg use

目的探讨抗菌药物暴露与鲍曼不动杆菌(Ab)感染暴发病例的相关性,分析多重耐药菌筛选产生的原因,并为临床提供延缓耐药菌产生的策略。方法 2016年5月3日—18日ICU病区7例患者下呼吸道标本中连续检出7株多重耐药鲍曼不动杆菌(MDRAB),对这7株MDRAB检出前使用的抗菌药物进行分析,并对检出后抗感染治疗方案给予合理性评价。结果排除因抗菌药物前期暴露导致此起感染暴发的原因,考虑为耐药菌播散所致;7例中4例为定植菌,3例患者不除外MDRAB导致的感染;给予的治疗方案欠合理,经治疗后2例有效,病情趋于稳定,1例无效自动出院。结论抗菌药物选择性压力是导致首例耐药菌产生的原因,应引起高度重视,避免抗菌药物滥用,延缓细菌耐药性的产生。

Objective Cbjective Intensive care unit（ICU）Acinetobacter baumannii（Ab）outbreak of infections antimicrobial dr μg use analysis,analyze the causes of multi-resistant bacteria were screened for production and to provide delay the resistant clinical strategy.Methods In May 2016,just 15 days at the 7 patients in ICU respiratory specimens checked out seven consecutive multi-dr μg resistant Acinetobacter baumannii（MDRAB）. This paper analyzes the antimicrobial agents 7MDRAB detected before use and to evaluate the reasonableness of administration after the detection of anti-infection treatment programs.Results Early exposure to antimicrobial dr μgs excluded from causing this infection outbreak reasons to consider due to the spread of resistant bacteria;7 cases,4 cases of bacterial colonization,3 patients could not be excluded MDRAB cause infection;less reasonable given treatment regimen,treatment after two cases of valid condition stabilized,and 1 invalid automatically discharged.Conclusion Selective pressure of antimicrobial drμgs is the cause of the first case of resistant bacteria,and attention should be paid to avoid the abuse of antibiotics,anti-bacterial dr μg resistance.