摘要
目的探讨人苍白杆菌引起重症患者医院获得性感染的危险因素、产AmpC酶情况及耐药现状,为有效预防和治疗该菌感染提供科学依据。方法回顾性调查2011年1月-2016年8月重症医学科患者的临床资料,常规方法分离鉴定细菌,改良三维试验进行产AmpC酶检测,K-B纸片扩散法进行药敏试验,利用WHONET 5.6软件分析处理药敏试验结果。结果人苍白杆菌引起重症患者感染的主要危险因素有中央静脉插管、手术、机械通气等,该菌主要来自血液标本,产AmpC酶为70.3%,对含酶抑制剂、青霉素类、一代~三代头孢类、单环β-内酰胺类抗菌药物均有很强的耐药性,耐药率均>90.0%,对四代头孢类、复方磺胺类、氨基糖苷类、喹诺酮类、碳青酶烯类和四环素类等抗菌药物保持较低的耐药率,耐药率均<20.0%。结论侵入性诊疗是引起重症患者感染人苍白杆菌的主要危险因素,该菌主要引起血流感染,产AmpC酶率高,对β-内酰胺酶类抗菌药物高度耐药,治疗该菌感染首选氨基糖苷类、喹诺酮类、碳青酶烯类和四环素类等抗菌药物。
Objective To investigate the risk factors,producing AmpC and drug resistance status of hospital acquired infections in critical patients caused by Ochrobactrum anthropi,so as to provide scientific basis for effective prevention and treatment of the bacterial infection. Methods Retrospective study was performed on the clinical data of critical patients from January 2011 to August 2016; conventional methods were used for isolation and identification of bacteria,modified three dimensional test was adopted for the detection of AmpC enzyme,K- B paper diffusion method was used for drug sensitivity test,and WHONET 5. 6was used to analyze the results of drug sensitivity test. Results The main risk factors of infection in critical patients with hospital acquired infection caused by Ochrobactrum anthropi were central venous catheterization,surgery,mechanical ventilation and so on; the bacteria was mainly from blood specimens,and the production of AmpC enzyme was 70. 3%,which had very strong resistance to enzyme inhibitor,penicillin,the first to the three generation cephalosporin,monocyclic β- lactam of antibiotics,with the resistance rates more than 90. 0%; and it had low resistance to the fourth generation cephalosporin,compound sulfonamides,aminoglycosides,quinolones,carbapenems and tetracycline antibiotics,with the resistance rates less than 20. 0%.Conclusion Invasive diagnosis and treatment are the main risk factors for critical patients with hospital acquired infection caused by Ochrobactrum anthropi,which always causes high blood infection and high production of AmpC enzyme and high resistance to beta lactam antibiotics; so the first choice in treating the infections caused by Ochrobactrum anthropi are aminoglycosides,quinolones,carbapenems and tetracycline antibiotics.
出处
《中国卫生检验杂志》
CAS
2017年第2期288-291,共4页
Chinese Journal of Health Laboratory Technology
关键词
重症患者
医院获得性感染
人苍白杆菌
AMPC酶
耐药现状
Critical patients
Hospital acquired infection
Ochrobactrum anthropi
AmpC enzyme
Drug resistance status
