摘要
目的 监测烧伤病房鲍氏不动杆菌耐药性趋势和同源性情况.方法收集2008年11月-2009年2月、2010年6-9月笔者单位住院烧伤患者创面、血液和静脉导管分离的鲍氏不动杆菌26株,采用K-B纸片扩散法检测该菌对阿米卡星、庆大霉素等13种临床常用抗生素的耐药性,用重复序列PCR法检测基因分型.对细菌耐药率数据进行x2检验.结果 （1）26株鲍氏不动杆菌中多药耐药菌株16株、泛耐药菌株9株,菌株对庆大霉素、哌拉西林、哌拉西林/他唑巴坦、头孢呋辛、头孢噻肟、头孢他啶、头孢吡肟、环丙沙星、亚胺培南和美罗培南的耐药率均高达90.00%以上;对头孢哌酮/舒巴坦的耐药率最低,为42.31%（11/26）.26株鲍氏不动杆菌对13种抗生素的耐药率比较,差异有统计学意义（42.31%～100.00%,χ2=97.371,P＜0.05）.（2）26株鲍氏不动杆菌共分为7个基因型：A型17株,B型3株,C型2株,D、E、F、G型各1株.17株A型菌株中,2008、2009年各1株,2010年15株;创面来源11株、血液和静脉导管来源共6株.结论笔者单位烧伤病房近年来存在鲍氏不动杆菌同一克隆株A型的流行,对临床常用抗生素呈多药耐药或泛耐药趋势.目前头孢哌酮/舒巴坦是治疗烧伤患者鲍氏不动杆菌感染的首选药物.
Objective To monitor genotypes and drug-resistance trend of Acinetobacter baumannii （AB） isolated from burn wards. Methods Twenty-six strains of AB isolated from wound secretion, venous catheter, and blood were collected from burn patients hospitalized in our burn wards from November 2008 to February 2009, and June to September 2010. Homogeneous genotype analysis was performed with repetitive extragenic palindromic PCR, and drug-resistance rate to 13 antibiotics including amikacin, gentamicin, etc. , which were commonly used in clinic, was tested by K-B paper disk diffusion. The data of drugresistance rate were processed with chi-square test. Results （ 1 ） Sixteen AB strains were multi-drug resistant （MDR）, 9 AB strains were pan-drug resistant （PDR）. Among all strains, the resistance rate to gentamicin, piperacillin, piperacillin/tazobactam, cefuroxime, cefotaxime, ceftazidime, cefepime, ciprofloxacin, imipenem, and meropenem was respectively higher than 90.00%; the resistance rate against cefoperazone/sulbactam was the lowest （11/26, 42.31% ）. There were obvious difference among the drug-resistance rates of AB strains to 13 antibiotics （with rates from 42.31% to 100.00% , x 2 = 97. 371, P 〈 0.05 ）. （2）There were 7 genotypes among 26 AB strains, respectively type A （ 17）, type B （3）, type C （2） , type D （1）, type E （1）, typeF （1）, and typeG （1）. Out of the 17 AB strains inAgenotype, 1 strain was from 2008, 1 strain was from 2009, 15 strains were from 2010, and among them 11 strains were collected from wound secretion and 6 strains were obtained from blood and venous catheter. Conclusions AB strains in A genotype are dominant in our burn wards in recent years, which are MDR or PDR to commonly used antibiotics. Cefoperazone/sulbactam is the drug of choice for burn patients with AB infection.
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2011年第2期92-94,共3页
Chinese Journal of Burns
关键词
烧伤
鲍氏不动杆菌
基因型
抗菌药
抗药性
重复序列PCR
Burns
Acinetobacter baumannii
Genotype
Anti-bacterial agents
Drug resistance
Repetitive extragenic palindromic polymerase chain reaction
