320株鲍曼不动杆菌临床分布和耐药性分析.docVIP

320株鲍曼不动杆菌的临床分布及耐药性分析 安宝清1王金侠2 [摘要] 目的：了解我院年鲍曼不动杆菌医院内感染分布特点及耐药趋势，为制定预防和控制其医院感染的措施提供依据，并指导临床合理使用抗生素。方法：常规分离我院细菌，采用美国Walk-away - 40全自动细菌鉴定仪进行菌株鉴定。采用琼脂纸片扩散法（K-B 法）对临床分离株进行药敏实验，参照CLSI 判断标准，采用标准菌株大肠埃希菌ATCC25922、铜绿假单胞菌A TCC27853为质控菌株，用WHONET5. 4 统计软件进行数据处理和分析。结果：共分离鉴定鲍曼不动杆菌320株，从痰标本中分离261株，占81.6 %，其次从伤口分泌物标本中分离19株，占5.9%，在血液及脑脊液中的分离率分别为16株（5.0%）及6株（1.9%）。我院鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率为59.1%，左旋氧氟沙星为74.6%，莫西沙星为75.3%，亚胺培南为79.7%，对其它12种抗生素的耐药率均大于80%；泛耐鲍曼不动杆菌（PDRAB）检出率为33.1%。结论： 鲍曼不动杆菌已成为我院医院感染尤其是ICU感染的主要病原菌，且耐药形势严峻；对泛耐药的鲍曼不动杆菌感染的患者应以头孢哌酮/舒巴坦第一线抗菌药物；鉴于对亚胺培南的高耐药率，应慎用碳青霉烯类药物。 [关键词] 　鲍曼不动杆菌；医院感染；耐药性 Clinical distribution and resistance characteristic analysis of 320 Acinetobacter baumannii strains An Bao Qing, Wang Jin Xia ：Department of Clinical Laboratory Tests，Chang Li Hospital of Chinese Medine，Qin Huang Dao Second Hospital，Hebei，066600 [ Abstract] Objective: To analysis the clinical distribution and resistance characteristics in isolates of Acinetobacter baumannii (Ab) , and provide evidence for clinical prevention and therapy. Materials and Methods : Routine bacteria culture and AmericanWalkaway - 40 identification system were adopted for bacteria identification. Susceptibility was tested by Kirby – Bauer method, refering to SLSI criterion, employing Escherichia coli ATCC25922 and Pseudomonas aeruginosa ATCC27853 as the standard stains. Analyze the data by WHONET5. 4 software. 作者 ： 1 河北省昌黎县中医院检验科 2 秦皇岛市第二医院检验科 河北昌黎066600 Results: The majority of isolates were from sputum (261 strains , account for 81.6 %) , followed by wound secretion(19 stains, 5.9% ); then blood (16 stains, 5.0%)and cerebrospinal fluid(6 stains, 1.9%). The resistance rate to Cefoperazone and Sulbactam is 59.1%, Levofloxacin 74.6%, moxifloxacin 75.3%)and Imipenem 79.7%. the resistane rates to other antibiotics are higher(80%).The detection rate for pandrug- resistant Acinetobacter baumannii is 33.1%. Conclusions: Acinetobacter baumanii greatly contributes to nosocomial infections, especialy in ICU ward.