摘要
目的探讨脑出血危重患者多药耐药鲍氏不动杆菌感染与耐药性,为合理选择抗菌药提供参考依据。方法选取2011年1月-2014年12月医院收治的298例脑出血危重患者,对感染病原菌进行菌株鉴定及药敏分析;采用SPSS20.0软件对数据进行统计分析。结果 322份标本培养分离到病原菌468株,其中52株为多药耐药鲍氏不动杆菌,检出率为11.11%,以痰液和脑脊液检出为主,分别占48.08%和21.15%;2011-2014年分别检出多药耐药鲍氏不动杆菌7、11、15、19株,检出率分别为7.61%、10.38%、11.90%和13.19%;2011-2014年多药耐药鲍氏不动杆菌耐药率较高,多>60.00%,且存在上升趋势;logistic回归分析显示,入住ICU时间、GCS评分、APACHEⅡ评分、呼吸机使用时间和气管插管或气管切开为多药耐药鲍氏不动杆菌感染的独立危险因素(P<0.05)。结论多药耐药鲍氏不动杆菌的耐药率较高,临床上应根据药敏试验结果合理选择抗菌药物治疗,应积极预防控制多药耐药鲍氏不动杆菌的感染。
OBJECTIVE To explore the prevalence of multidrug-resistant Acinetobacter baumannii infections in patients with severe cerebral hemorrhage and analyze the drug resistance so as to provide guidance for reasonable use of antibiotics.METHODS A total of 298 patients with severe cerebral hemorrhage who were treated in the hospital from Jan 2011 to Dec 2014 were enrolled in the study,then the pathogens causing infections were identified,the drug susceptibility testing was carried out,and the statistical analysis of data was performed with the use of SPSS20.0software.RESULTS Totally 468 strains of pathogens were isolated from 322 specimens,of which 52 were multidrug-resistant A.baumannii,with the isolation rate of 11.11%;48.08% of the strains were isolated from sputum specimens,and 21.15% of the strains were isolated from cerebrospinal fluid specimens.Totally 7strains of multidrug-resistant A.baumannii were isolated in 2011,11 strains in 2012,15 strains in 2013,19 strains in 2014,and the isolation rates were 7.61%,10.38%,11.90%,and 13.19%,respectively.The drug resistant rate of the multidrug-resistant A.baumannii strains was more than 60.00%in 2011-2014,showing an upward trend.The logistic regression analysis indicated that the independent risk factors for the multidrug-resistant A.baumannii infection included the length of ICU stay,GCS score,APACHEⅡ score,time of use of ventilator,and endotracheal intubation or tracheotomy（P〈0.05）.CONCLUSIONThe drug resistance rate of the multidrugresistant A.baumannii is high.It is necessary for the hospital to reasonably use antibiotics based on the results of the drug susceptibility testing and actively take prevention measures for the multidrug-resistant A.baumannii infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第1期65-67,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(C03008)
关键词
脑出血
多药耐药
鲍氏不动杆菌
Cerebral hemorrhage
Multidrug-resistant
Acinetobacter baumannii
