ICU与非ICU病房鲍曼不动杆菌临床分布及耐药性分析

Clinical distribution and drug resistance of Acinetobacter baumannii from ICU and non-ICU wards

关键词:  鲍曼不动杆菌  耐药性  医院感染

Key words:  [Key words]　Acinetobacter baumannii  drug resistance  nosocomial infection

摘要:

[摘要]　目的　统计分析大连医科大学附属第一医院鲍曼不动杆菌的临床分布及对常用抗菌药物的耐药性，并比较ICU病房与非ICU病房分离的鲍曼不动杆菌的耐药率差异。　方法　2013年1月至2014年3月共分离鲍曼不动杆菌801株，其中ICU病房519株，占64.79%；非ICU病房282株，占35.21%。标本主要来源于痰液、尿液、血液、胸腹水、脑脊液、伤口分泌物等。利用全自动细菌鉴定及药敏分析仪进行细菌鉴定及药敏测定，补充药敏试验采用K-B纸片扩散法。采用WHONET软件对鲍曼不动杆菌分布及耐药性进行分析。　结果　801株鲍曼不动杆菌对15种所测抗生素均具有较高耐药性，其中对米诺环素耐药率略低，为31.5%。ICU病房来源鲍曼不动杆菌对每种抗生素的耐药率均显著高于非ICU病房，差异具有非常显著性意义。　结论　ICU病房来源的鲍曼不动杆菌耐药率显著高于非ICU病房分离株，加强鲍曼不动杆菌的控制与监测，临床医师更应结合药敏试验结果合理使用抗菌药物以降低鲍曼不动杆菌的耐药率。

Abstract:

[Abstract]　Objective　To analyze clinical distribution and antibiotic resistance of Acinetobacter baumannii in our hospital, and to compare resistance rates of A. baumannii isolated from ICU and non-ICU wards.　Methods　A total of 801 samples were A. baumannii positive from Jan 2013 to Mar 2014, 519 (64.79%) samples were from ICU， while 282 (35.21%) were from non-ICU wards. The clinical specimens mainly included sputum, urine, blood, Pleural and peritoneal effusions, cerebrospinal fluid, wound secretion and so on. Bacterial identification and antibiotics susceptibility test were performed by automated bacterial identification and susceptibility analyzers. And complementary drug susceptibility test was performed by K-B disc diffusion method. WHONET software was used to analyze clinical distribution and antibiotic resistance of A. baumannii.　Results　A. baumannii in all of 801 samples kept higher resistance to 15 antibiotics. The drug resistance rate to minocycline was relatively low (31.5%), The resistance rate to each antibiotic of A. baumannii isolated from ICU was significantly higher than those isolated from non-ICU wards.　Conclusion　We should pay more attention to monitor the infection of A. baumannii and control the increasing drug resistance rate.