摘要
目的通过近3年不动杆菌在蚌医一附院院内分布特征和耐药状况的分析,为医院各临床科室预防院内感染及对本菌感染的细菌学诊断和治疗提供系统、准确的依据。方法采用法国梅里埃VITEK32自动鉴定仪对各种标本中分离的细菌进行鉴定,同时采用VITEK32或纸片扩散法(K-B)法对分离的不动杆菌做药敏试验。结果从2008年1月1日-2010年12月31日工检出834株不动杆菌,鲍曼不动杆菌为735株,其他不动杆菌为99株。细菌在各病区分布特征主要是ICU占58.0%,呼吸科占27.3%,其他科室占14.7%;在选用的18种抗生素的药敏试验中,头孢哌酮/舒巴坦平均耐药率最低,但已达60%以上,复方新诺明、亚胺培南、美洛培南的平均耐药率分别为73.6%、86.0%、86.9%。其他抗生素基本上处在较高的、稳定的耐药状态。结论鲍曼不动杆菌已成为引起感染和医院感染的仅次于铜绿假单胞菌的非发酵菌之一,耐药情况不容乐观,应引起临床各科室高度重视。严格规范不动杆菌感染的抗菌治疗,减少因治疗而诱导耐药酶产生导致的耐药菌,以防止耐药种类和耐药菌株的逐年攀升。
Objective To analysis the distribution and drug resistance of Acinetobacter baumannii in our hospital and provide references for the clinic bacteriological diagnosis,therapy and prevention of nosocomial infection.Methods VITEK32 system was used for the bacterial identification from the isolated samples;the drug sensitive tests for Acinetobacter were performed by VITEK32 system or K-B method.Results From Jan.2008 to Dec.2010,834 strains of Acinetobacter were isolated,in which 735 were Acinetobacter baumannii strains and 99 were other strains,58.0% of the strains were from ICU,27.3% from the department of respiration and 14.7% from the other departments,In the drug sensitive tests with 18 antibiotics,the resistance rate to cefoperazone/sulbactam was the lowest,which was 60%,to trimethoprim-sulfamethoxazole,imipenem and meropenem was 73.6%,86.0% and 86.9%,respectively,And the others antibiotics were higher.Conclusion Acinetobacter baumannii is one of the non-fermentative bacteria in hospital infection followed Pseudomonas aeruginosa.The drug resistance rate to most antibiotics obviously shows uptrend,Therefore,more attention should be paid to the monitoring of its drug resistance and infection treatment.The effective measures,such as the standard antimicrobial treatment to Acinetobacter which can decrease the chance of antibiotic resistance enzyme,should be taken to prevent the occurrence of pan-resistant strains.
出处
《中华全科医学》
2012年第5期788-788,821,共2页
Chinese Journal of General Practice
