摘要
目的调查儿童重症监护病房(PICU)鲍氏不动杆菌(ABA)临床分布特点及耐药情况,为合理选用抗菌药物提供依据。方法采用VITEK-32微生物全自动鉴定系统鉴定细菌,以纸片扩散法进行药敏试验,按CLSI标准操作。结果 2007-2009年共检出329株,其中2007年45株、2008年74株、2009年210株,分别占当年总检出率的9.57%、12.67%和24.33%;大部分菌株来源于痰液及支气管吸出物标本,占89.36%;基础疾病以肺炎最多,占80.24%;药敏结果显示,常用抗菌药物耐药性普遍较高,呈逐年上升趋势,其中青霉素类、头孢菌素类(头孢哌酮/舒巴坦除外)抗菌药物耐药率均>70.0%,亚胺培南、美罗培南平均耐药率>60.0%;阿米卡星、左氧氟沙星、环丙沙星耐药率最低,分别为0.45%、1.97%、2.48%。结论 ABA感染在PICU不断增加,常用抗菌药物表现多药耐药性,且呈逐年上升趋势;临床上应进行规范的连续耐药监测,依据病原学及耐药性资料,合理选择抗菌药物;同时加强医院环境和人员消毒,控制ABA在PICU定植与播散。
OBJECTIVE To investigate the distribution of clinical strains and antibiotic resistance of Acinetobacter baumannii（ABA） in the pediatric intensive care unit（PICU） and to provide evidence for reasonable use of antibiotics.METHODS VITEK-32 automicroscan was used to identify the species.Susceptibility was tested by Kirby-Bauer method.The results were interpreted according to the guideline of Clinical and Laboratory Standards Institute.RESULTS 329 clinical strains of ABA were isolated from 2007 to 2009,（45 in 2007（9.57%）,74 in 2008（12.67%） and 210 in 2009（24.33%））.The strains of ABA were mainly isolated from sputum and tracheal aspirates（89.36%）,and pneumonia was the most common basic disease in PICU（80.24%）.The results of drug susceptibility tests indicated that the antibiotic resistance rate of ABA was generally high and increased by years.Amikacin,Levofloxacin and Ciprofloxacin had the lowest drug-resistance（3%）,followed by Cefoperazone-sulbactam（17.14%）.To the other antibiotics such as Penicillins and Cephalosporins,the rates of drug-resistance were more than 70%.The average rate to Imipenem and Meropenem was higher than 60.0%.CONCLUSIONS The infection of multidrug-resistant ABA has increasing tendency in PICU.It should continue to strengthen the monitoring of the antibiotic resistance and select antibiotics according to the drug sensitivity test.Meanwhile the disinfection should be strengthened for hospital environment in order to control the existence and spread of ABA in PICU.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2011年第11期2348-2350,共3页
Chinese Journal of Nosocomiology
关键词
儿童
重症监护病房
鲍氏不动杆菌
耐药性
Pediatric Intensive Care Unit（PICU）
Acinetobacter baumannii
Drug resistance
