鲍曼不动杆菌感染调查及药敏分析

Clinical investigation and resistance analysis of A.baumannii

关键词:  鲍曼不动杆菌  抗菌药物  耐药

Key words:  acinetobacter baumannii  antibiotic drug  resistance

摘要:

［目的］探讨鲍曼不动杆菌的感染和药敏情况，指导临床合理用药。［方法］采用API细菌鉴定试条(法国生物梅里埃公司产品) 鉴定细菌到种；K-B纸片扩散法进行药物敏感试验, WHONET5.3软件进行统计学分析。［结果］ 鲍曼不动杆菌2003～2005年检出率分别为6.37%、9.75%、6.56%,在临床分离的非发酵菌中仅次于铜绿假单胞菌位居第二。标本主要来源于痰（84.5%）,病房集中于中心ICU（33.8%）、急诊病房（11.2%）、呼吸内科（10.6%）。该菌耐药现象严重，对哌拉西林、头孢噻肟、头孢曲松、氨曲南呈多重耐药，敏感度最高的是亚胺培南，为70.0%，最低的是头孢噻肟,几乎100%耐药。［结论］鲍曼不动杆菌是引起医院感染的常见条件致病菌。该菌耐药性广，临床治疗应合理选择使用抗菌药物，加强医院环境和人员消毒，控制不动杆菌在医院内的定值和播散。

Abstract:

［Objective］To investigate the clinical distribution and resistance of Acinetobacter Baumannii in order to provide evidence to proper use of antibiotic drugs in clinics．［Methods］ A. baumannii was identified by BioMerieux API system and drug sensitive tests were performed by K～B test，the data were analyzed by WHONET5.3 software．［Results］The isolating rate of A. baumannii from 2003 to 2005 is 6.37%、9.75%、6.56%,it is second only Pseudomonas aeruginosa in clinical divorced no-zymocyte. A. baumannii main from center ICU (33.8%)、emergency ward(11.2%)、anapnea ward(10.6%).Sputum specimen counted for 84.5％． A. baurnannii had high drug resistances to PIP、CTX、CRO、ATM． A．baumannii showed the highest susceptibility to IPM with 70% susceptible rate,it also showed the highest resistance to CTX with almost 100% resistant rate.［Conclusion］ The infection of A．baumannii is one of the most complex problems． Therefore，monitoring A．bamnannii constantly and regularly，finding out resistant strains timely，and adjusting the treatment regimen is very important to the prevention of nosocomial infection． The disinfection should be strengthened for hospital environment and medical staff in order to control existence and spread of A．bamnannii.