中华危重病急救医学
中華危重病急救醫學
중화위중병급구의학
Chinese Critical Care Medicine
2013年
6期
369-372
,共4页
孙成栋%李真%刘斯%王燕
孫成棟%李真%劉斯%王燕
손성동%리진%류사%왕연
泛耐药鲍曼不动杆菌%医院感染%抗菌药物%耐药性
汎耐藥鮑曼不動桿菌%醫院感染%抗菌藥物%耐藥性
범내약포만불동간균%의원감염%항균약물%내약성
Pan-drug-resistant Acinetobacter baumannii%Hospital infection%Antibiotic%Drug-resistance
目的 了解泛耐药鲍曼不动杆菌医院感染现状及其对临床常用抗菌药物的耐药情况,为合理应用抗菌药物提供依据.方法 收集本院2009年1月至2012年12月住院患者的各类微生物检测标本,对标本进行细菌培养和分离.采用VITEK 2-Compact全自动微生物分析仪进行鉴定和药敏分析.结果 4年共分离出307株泛耐药鲍曼不动杆菌,主要来源为呼吸道分泌物(69.4％),其次为创面分泌物(14.7％)；以重症监护病房(ICU,占26.4％)、呼吸科(占26.1％)、老年病科(占23.1％)的检出率最高；对临床常用抗菌药物几乎完全耐药,头孢噻肟、哌拉西林、美罗培南、亚胺培南、环丙沙星、四环素等药物的耐药率可高达100％,除了头孢哌酮/舒巴坦与多黏菌素外,其他药物的耐药率均在90％以上；即使是头孢哌酮/舒巴坦在本院的泛耐药鲍曼不动杆菌中也有近约30％的耐药率,但对多黏菌素的耐药率为0.结论 泛耐药鲍曼不动杆茵对多数临床常用抗菌药物表现为耐药,根据药敏结果选用抗菌药物,针对泛耐药鲍曼不动杆菌的感染可选用多黏菌素与头孢哌酮/舒巴坦或者含舒巴坦制剂的药物.
目的 瞭解汎耐藥鮑曼不動桿菌醫院感染現狀及其對臨床常用抗菌藥物的耐藥情況,為閤理應用抗菌藥物提供依據.方法 收集本院2009年1月至2012年12月住院患者的各類微生物檢測標本,對標本進行細菌培養和分離.採用VITEK 2-Compact全自動微生物分析儀進行鑒定和藥敏分析.結果 4年共分離齣307株汎耐藥鮑曼不動桿菌,主要來源為呼吸道分泌物(69.4％),其次為創麵分泌物(14.7％)；以重癥鑑護病房(ICU,佔26.4％)、呼吸科(佔26.1％)、老年病科(佔23.1％)的檢齣率最高；對臨床常用抗菌藥物幾乎完全耐藥,頭孢噻肟、哌拉西林、美囉培南、亞胺培南、環丙沙星、四環素等藥物的耐藥率可高達100％,除瞭頭孢哌酮/舒巴坦與多黏菌素外,其他藥物的耐藥率均在90％以上；即使是頭孢哌酮/舒巴坦在本院的汎耐藥鮑曼不動桿菌中也有近約30％的耐藥率,但對多黏菌素的耐藥率為0.結論 汎耐藥鮑曼不動桿茵對多數臨床常用抗菌藥物錶現為耐藥,根據藥敏結果選用抗菌藥物,針對汎耐藥鮑曼不動桿菌的感染可選用多黏菌素與頭孢哌酮/舒巴坦或者含舒巴坦製劑的藥物.
목적 료해범내약포만불동간균의원감염현상급기대림상상용항균약물적내약정황,위합리응용항균약물제공의거.방법 수집본원2009년1월지2012년12월주원환자적각류미생물검측표본,대표본진행세균배양화분리.채용VITEK 2-Compact전자동미생물분석의진행감정화약민분석.결과 4년공분리출307주범내약포만불동간균,주요래원위호흡도분비물(69.4％),기차위창면분비물(14.7％)；이중증감호병방(ICU,점26.4％)、호흡과(점26.1％)、노년병과(점23.1％)적검출솔최고；대림상상용항균약물궤호완전내약,두포새우、고랍서림、미라배남、아알배남、배병사성、사배소등약물적내약솔가고체100％,제료두포고동/서파탄여다점균소외,기타약물적내약솔균재90％이상；즉사시두포고동/서파탄재본원적범내약포만불동간균중야유근약30％적내약솔,단대다점균소적내약솔위0.결론 범내약포만불동간인대다수림상상용항균약물표현위내약,근거약민결과선용항균약물,침대범내약포만불동간균적감염가선용다점균소여두포고동/서파탄혹자함서파탄제제적약물.
Objective To investigate current situation of pan-drug-resistant Acinetobacter baumannii in hospital and its drug-resistance,then provide reference for rational use of antibiotics in clinic.Methods All kinds of microbial test specimens from January 2009 to December 2012 of hospitalized patients were cultured and separated.VITEK 2-Compact fully automatic microorganism analyzer was used to identify and analyze drug sensitivity.Results Three hundred and seven strains pan-drug-resistant Acinetobacter baumannii were isolated in 4 years,the primarily source were sputum,accounted for 69.4％,followed by the wound secretion 14.7％.The highest three places of samples separation of extensive drug-resistant Acinetobacter baumannii positive was intensive care unit (ICU,accounted for 26.4％),department of respiratory medicine (accounted for 26.1％) and department of geriatrics (accounted for 23.1％).Extensive drug-resistant Acinetobacter baumannii almost completely resisted to clinical commonly used antimicrobial agents,drug resistant rate could be as high as 100％ such as cefotaxime,meropenem,piperacillin,imipenem,ciprofloxacin,and tetracycline except for cefoperazone-sulbactam and polymyxin,and the rate of other drugs were all above 90％.Drug-resistant of cefoperazone-sulbactam was nearly 30％ in our hospital,and sensitive rate was 100％ to polymyxin.Conclusions Pan-drug-resistant Acinetobacter baumannii is resistant for most clinical commonly used antimicrobial drug,antimicrobial agents were chosen according to drug susceptibility testing.Antibacterial drugs such as polymyxin and cefoperazone-sulbactam or sulbactam contained drugs can be selected for pan-drug-resistant.
