摘要
目的分析2007-2008年蚌埠市中心医院ICU鲍氏不动杆菌的感染及耐药性特点,探讨对鲍氏不动杆菌感染的防治措施,并指导临床合理应用抗菌药物。方法以回顾性调查的方法对2007-2008年医院ICU住院患者,鲍氏不动杆菌医院感染的发生率、病死率、耐药分析;鲍氏不动杆菌感染发生部位、易感因素以及发生前应用碳青酶烯类抗菌药物情况等临床资料进行统计分析。结果 2年来在75例医院感染患者中共分离出150株病原菌,其中鲍氏不动杆菌感染病例27例(36.0%),分离出鲍氏不动杆菌28株,为最多见细菌感染(18.7%);鲍氏不动杆菌对常用抗菌药物有不同程度的耐药,其中对亚胺培南、美罗培南、阿莫西林、阿米卡星、磺胺甲噁唑/甲氧苄啶、头孢他啶的敏感性分别为50.0%、32.1%、25.0%、25.0%、25.0%和21.4%,其余均<20.0%;鲍氏不动杆菌感染发生于下呼吸道24例(88.9%),其中呼吸机相关性肺炎23例(95.8%);混合感染或多部位感染发生的鲍氏不动杆菌感染(77.8%)概率高(P<0.01);发生鲍氏不动杆菌感染前应用碳青酶烯类抗菌药物患者(77.8%)易发生鲍氏不动杆菌感染(P<0.01)。结论 ICU的鲍氏不动杆菌医院感染问题突出,对常用抗菌药物的耐药现象十分严重,应严格掌握碳青酶烯类抗菌药物使用指征。
OBJECTIVE To investigate the charalteristics Acinetobacter baumannii infection and reasonable application of antibiotics through analyzing infection and drug resistance feature of A.baumannii in ICU in Bengbu Central Hospital from 2007 to 2008.METHODS To analyze incidence,fatality rate and resistance of nosocomial infection caused by A.baumannii in patients in ICU from 2007 to 2008 through retrospective study.Their clinical datas,predisposing factors of A.baumannii infection and the application of carbapenems were analyzed statistically.RESULTS Totally 150 pathogenic bacteria were isolated from 75 patients with nosocomial infection.There were 27 cases with A.baumannii infection（36%） and 28 isolated strains.The most bacterial infection was A.baumannii infection.A.baumannii was resistant to commonly used antibacterials with different degree.It was sensitive to imipenem,meropenem,amoxicillin,amikacin,Smzco and ceftazidime,（50.0%,32.14%,25.0%,25.0%,25.0% and 21.43%,respectively）.The others were all less than 20%.Twenty-four cases were with A.baumannii infection in lower respiratory tract（88.89%）.The VAP was in 23 cases（95.83%）.The probability of mixed infection and multiple infection of A.baumannii was hige（P〈0.01）.The patients using carbapenems（77.78%） before infection were easy to acquire A.baumannii infection（P〈0.01）.CONCLUSION The question of A.baumannii infection in ICU is outstanding.The resistance to commonly used antibacterials is severe.We should master the application indication of carbapenems strictly.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第13期1931-1933,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
鲍氏不动杆菌
医院感染
耐药性
Intensive care unit
Acinetobacter baumannii
Nosocomial infection
Resistance
